ecancermedicalscience

Research

Pre-operative systemic therapy in locally advanced breast cancer: a single institution experience

12 Oct 2009
EM Ibrahim, AM Al-Gahmi, JM Zekri, SS Awadalla, TR Elkhodary, EE Fawzy, YA Bahadur, ME Elsayed, A Zeeneldin, RH Al-Ahmadi, AH Linjawi

Background: Locally advanced breast cancer (LABC) is common in developing countries and it frequently affects younger women. Patients do very poorly when treated by locoregional therapy alone; therefore, pre-operative systemic therapy (PST) is commonly used.

Materials and methods: Medical records of 64 Saudi patients with LABC treated with PST in a single institution were retrospectively reviewed.

Results: At diagnosis, most patients were young (median age 41 years), and had poor clinicopathological characteristics. Following surgery, complete pathologic response (pCR) in the breast was achieved in 13 patients (20%). Of 62 patients with known nodal status, 22 (34%) had negative axillary nodes. Presence of oestrogen receptor (ER) negative tumour was the only dependent variable that predicted pCR in the breast (p = 0.03). At a median follow-up of 42 months, the median progression-free survival (PFS) was 48 months (95% CI, 20–76 months) and the projected five-year overall survival (OS) was 68%. The recently published scoring system (Jeruss et al (2008) J Clin Oncol 26 2 246–52), was the only variable that independently influenced PFS, while ER negative tumours and presence of lymphovascular space invasion were the only factors that adversely affected OS.

Conclusions: despite the use of standard multi-modality approach in the management of patients with LABC, prognosis remains guarded.

Related Articles

Johnblack K Kabukye, Alice B S Nono Djotsa, Adedayo Joseph, Charles Muya, Benda N Kithaka, Mishka K Cira, Leshia Hansen, Annet Nakaganda
Nashivai E Kivuyo, Daniel W Kitua, Martin E Chikelea, Mungeni A Misidai, Ally H Mwanga, Obadia V Nyongole, Larry O Akoko
Nithiya Sinarajoo, Yek-Ching Kong, Ranjit Kaur, Ros Suzanna Bustamam, Nur Fadhlina Abdul Satar, Sharminii Jaya-Prakason, Harenthri Devy Alagir Rajah, Mahmoud Danaee, Cheng-Har Yip, Nirmala Bhoo-Pathy
Kofi Effah, Ethel Tekpor, Comfort Mawusi Wormenor, Joseph Emmanuel Amuah, Vida Kwawukume, Louisa Ademki Matey, Seyram Kemawor, Stephen Danyo, Esu Aku Catherine Morkli, Nana Owusu Mensah Essel, Emmanuel Timmy Donkoh, Patrick Kafui Akakpo