title: Efficacy of neoadjuvant chemotherapy in down staging locally advanced pre-menopausal breast cancer in Eastern Nigeria: is four courses adequate?
abstract: BACKGROUND
  Breast cancer is the most frequent cancer among women in most part of the world and in Nigeria. Neoadjuvant chemotherapy (NAC) has been demonstrated to be a helpful strategy in the context of locally advanced breast cancer (LABC).
  
  
  OBJECTIVE
  To determine if the use of four courses of doxorubicin based neoadjuvant chemotherapeutic regimen will result in significant primary tumor down-staging.
  
  
  METHODS
  One year prospective study of premenopausal breast cancer patients presenting to the specialty breast clinic.
  
  
  METHODS
  The patients were recommended for four courses of doxorubicin based NAC and response assessed using response evaluation criteria in solid tumors (RECIST) methodology.
  
  
  METHODS
  Simple frequency and descriptive statistics were used to analyze data using SPSS statistical software.
  
  
  RESULTS
  One hundred and fourteen patients presented with breast cancer. Their ages ranged from 26 to 51 years with a mean age of 42.1 years ± 7.7 years. Thirty-one patients completed the four courses of NAC. At the end of NAC, 23 (74.2%) patients had more than 30% reduction in primary tumor size and 8 (25.8%) had no response (NR). The response according to the modified RECIST methodology was 12.9% for a complete clinical response, 61.3% for partial response, and 25.8% for NR. Significant clinical response was seen in 74.2% of patients (P < 0.0001) (one sample t-test).
  
  
  CONCLUSIONS
  Four courses of antracycline based NAC is effective in premenopausal patients with LABC in our environment.
authors: Department of Surgery, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria.
authors: Ochonma Amobi
authors: OA
authors: Egwuonwu
authors: Stanley Nnamdi
authors: SN
authors: Anyanwu
authors: Alexander Maduaburochukwu
authors: AM
authors: Nwofor
mesh_terms: D000328:Adult; D000903:Antibiotics, Antineoplastic / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy*; D017024:Chemotherapy, Adjuvant; D003520:Cyclophosphamide / Q000627:therapeutic use; D004317:Doxorubicin / Q000627:therapeutic use; D005260:Female; D005472:Fluorouracil / Q000627:therapeutic use; D006801:Humans; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009549:Nigeria; D017697:Premenopause; D011379:Prognosis; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D000903:Antibiotics, Antineoplastic; D004317:Doxorubicin; D003520:Cyclophosphamide; D005472:Fluorouracil