ABSTRACT

Introduction:

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).

Materials and methods:

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.

Results:

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.

Conclusion:

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.