ABSTRACT

The rate of locally advanced breast cancer (LABC) is low in countries with organized population based mammographic screening (5-10%), but it is more than 50% in low-middle income countries. Aim of this study is to find factors affecting disease free and overall survival in patients with LABC after Neoadjuvant Chemotherapy (NAC).

322 patients who received NAC for LABC were enrolled in this study. Tru-cut biopsy (59%) and incisional biopsy (41%) were performed for histopathologic diagnosis, respectively. Most of the patients (97%) received NAC including antracycline. In 18% of patients, taxanes were added to the regime.

The complete (cPR) and partial pathologic response (pPR) rates were 6% and 84%, respectively. There were no response to NAC in 32 (10%) patients. NAC plus taxanes increased complete pathologic response rate to 15.5%. The 10-year rates of overall and disease free survival were 57% and 45%, respectively. The 10-overall survival rate was higher in patients with antracycline plus taxane group than other treatment group (64% vs 42%, p=0,009). Age (≤40), pPR, presence of lenfovascular invasion (LVI) and loco-regional and/or systemic recurrence, and negative hormonal receptors were significant factors affecting prognosis in univariate analysis. In multivariate analysis, young age(≤40), tumor size before NAC, pathologic stage after NAC, LVI, estrogen receptor (ER) negativity, HER2 positivity, and distant metastasis were indepent prognostic factors.

In addition to taxanes to NAC has increased cPR rate and overall survival in patients with LABC. Young age (≤40), presence of LVI, and systemic recurrence, and estrogen receptor (ER) negativity were significant factors affecting survival both in univariate and multivariate analyses.