title: Role of neo-adjuvant chemotherapy in locally advanced breast cancer.
abstract: OBJECTIVE
  Locally advanced breast cancer (LABC) is common in developing countries. The advancement of disease leads to decreased probability of radical cure and increase in treatment cost. The study evaluated neo adjuvant chemotherapy with MRM and MRM followed by adjuvant chemotherapy and also the effectiveness of neo-adjuvant chemotherapy in down staging advanced disease and offering radical cure.
  
  
  METHODS
  A rural hospital-based prospective comparative study.
  
  
  METHODS
  All histologically proven and investigated LABC (T3 N0, T3N1, Any T4, Any N2/N3, M0) were selected as subjects and divided into two groups. One group received neo adjuvant chemotherapy (5 fluorouracil, adriamycin and cyclophosphamide) followed by modified radical mastectomy and other group received adjuvant chemotherapy after modified radical mastectomy. Both groups were compared for disease free survival, overall survival and post-operative complications. Tumor response to chemotherapy in neo adjuvant group was also studied.
  
  
  METHODS
  All continuous variables were analyzed using student's' test and categorical variable by Fischer exact test.
  
  
  RESULTS
  Thirty one patients were enrolled, of these 16 patients received neo adjuvant chemotherapy. Clinical complete response was observed in two patients (12.5%). Clinical partial response was found in 12 patients (75%) and no response was seen in two patients (12.5%). Disease free survival and overall survival was 82% in neo adjuvant group while in adjuvant group disease free survival was 75% and overall survival was 83%. Post operative complications were similar in both groups.
  
  
  CONCLUSIONS
  Neo adjuvant chemotherapy helps in down staging LABC and offers opportunity in vivo to assess the effect of chemotherapy on individual basis. There was no significant difference in disease free survival, overall survival and post operative complication in between two groups.
authors.affiliation: Department of Surgery, NKP Salve Institute of Medical Sciences and Research Centre, Nagpur, Maharashtra, India.
authors.forename: M
authors.initials: M
authors.lastname: Akhtar
authors.forename: V
authors.initials: V
authors.lastname: Akulwar
authors.forename: A
authors.initials: A
authors.lastname: Kulkarni
authors.forename: A
authors.initials: A
authors.lastname: Bansal
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000473:pathology; D003520:Cyclophosphamide / Q000008:administration & dosage; D018572:Disease-Free Survival; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D008198:Lymph Nodes / Q000187:drug effects / Q000473:pathology; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy* / Q000473:pathology
chemical_list: D004317:Doxorubicin; D003520:Cyclophosphamide; D005472:Fluorouracil