Outcome of combined modality treatment including neoadjuvant chemotherapy of 128 cases of locally advanced breast cancer: data from a tertiary cancer center in northern India.
BACKGROUND
Breast cancer is now the most common cancer in many parts of India and the incidence varies from 12 to 31/100,000, and is rising. Locally advanced breast cancer (LABC) accounts for 30-35% of all cases of breast cancers in India. LABC continues to present a challenge and imposes a major health impact in our country.


METHODS
We carried out a analysis of our LABC patients who received neoadjuvant chemotherapy (NACT) at our hospital over a 10-year period, from January 1995 to December 2004. We analyzed the response to NACT, disease-free survival (DFS), and overall survival (OS).


RESULTS
Patients with stages IIIA, IIIB, and IIIC were included. LABC comprised of 26.24% (609 patients) of new patients. One hundred and twenty-eight (31.1%) patients received NACT. Median age was 48 years and estrogen receptor was positive in 64%. Chemotherapy protocol was an FEC (5-Fluorouracil, Epirubicin, Cyclophosphamide) regimen in the following doses: Cyclophosphamide 600 mg/m2, 5-FU 600 mg/m2, and Epirubicin 75 mg/m2 given every three weeks, six doses, followed by modified radical mastectomy (MRM) and locoregional radiotherapy. The overall response rate (complete response (CR) + partial response (PR)) was 84.4%, clinical CR (cCR) was 13.3% and pathological CR (pCR) was 7.8%. Median DFS and OS were 33 and 101 months, respectively. The disease-free survival (DFS) and overall survival (OS) at five years were 41 and 58%, respectively.


CONCLUSIONS
This study analyzes the outcome in patients who received NACT, in the largest number of LABC patients from a single center in India, and our results are comparable to the results reported from other centers.
Department of Medical Oncology, Surgical Oncology, and Radiation Oncology, Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi-29, India. vinodraina@hotmail.com
V
V
Raina
M
M
Kunjahari
N K
NK
Shukla
S V S
SV
Deo
A
A
Sharma
B K
BK
Mohanti
D N
DN
Sharma
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000628:therapy*; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000627:therapeutic use; D015251:Epirubicin / Q000627:therapeutic use; D005260:Female; D005472:Fluorouracil / Q000627:therapeutic use; D005500:Follow-Up Studies; D006801:Humans; D007194:India; D008408:Mastectomy; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
D015251:Epirubicin; D003520:Cyclophosphamide; D005472:Fluorouracil