Abstract
Introduction: Locally advanced breast cancer (LABC) is a disease with relatively poor prognosis. The incidence of LABC is high in India constituting about 30-35% of all cases. Neoadjuvant chemotherapy is the standard of care for patients with LABC. Concurrent chemoradiation is also investigated in LABC in neoadjuvant setting.
Aim: In this study we aimed to evaluate the histopathological patterns including the incidence of pathological complete response (pCR) after neoadjuvant chemotherapy or chemoradiation in our patient population with LABC and also to correlate various pathological and immunohistochemical parameters with pCR.
Materials and methods: We retrospectively analysed locally advanced breast cancer patients who underwent neoadjuvant chemotherapy (NACT) and neo-adjuvant chemoradiation (NACTRT) during the period Nov 2011-Jan 2014. The histopathological patterns and the incidence of pCR were assessed and correlated various pathological and immunohistochemical parameters with pCR. For statistical analysis Pearson's Chi-Square test and a binary logistic regression model were applied.
Results: Out of total 104 patients, 91 received NACT and 13 underwent NACTRT. pCR was 14.4%(15/104). 23% in (3/13) of NACTRT and 13.2% (12/91) of NACT group achieved pCR. In our study none of the pre-treatment parameters showed statistically significant association with pCR. The presence of LVE in the core biopsy and post-therapy surgical specimen (p-value 0.025) was significantly associated with axillary lymph node metastasis.
Conclusions: With limitations of being a retrospective analysis with small sample size, our study shows that in LABC following NACT or NACTRT, the probability of pCR is higher in tumors of high grade, ER negative, PR negative and Her2neu negative. The pCR after neoadjuvant chemoradiation was higher than neoadjuvant chemotherapy but was not found statistically significant.
Key-words: Locally advanced, neoadjuvant, chemotherapy, chemoradiation. retrospective.
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DOI: http://dx.doi.org/10.18535/jmscr/v4i2.24
