Clinicopathological response assessment to neoadjuvant chemotherapy in locally advanced breast cancer- A rural population-based case series

Introduction: Breast cancer is the commonest malignancy among women worldwide. Despite a multidisciplinary approach, locally advanced breast cancer remains a clinical challenge as most of the patient s have a high rate of locoregional spread and develop distant metastases. Neoadjuvant chemotherapy not only paves the way for a more conservative surgical option but also decreases the incidence of positive nodes. This study was undertaken , t o assess the effectiveness of neo adjuvant chemotherapy and its impact on clinical and pathological response in locally advanced breast cancer. It also, compare patient characte ristics, histological type, and hormonal receptor status with response to neo adjuvant chemotherapy chemotherapy. Materials and Methods: This is a prospective observational study over a one year period on ۳۰ locally advanced breast cancer patients from rural background who received neoadjuvant chemotherapy. All patients received a standard neoadjuvant treatment regimen and were ev aluated clinically, radiologically, and pathologically pre and post chemotherapy. The clinical response was assessed by RECIST criteria, the pathological response was graded according to Chevalier classification, and the overall impact was assessed by AJC C response criteria Results: Most of the patients (۴۶.۷%) were in the age group of ۳۵ ۴۸ years. The premenopausal and postmenopausal groups were ۶۳% and ۳۷%, respectively. In the present study, tumours expressing oestrogen, progesterone, and HER ۲ were ۷۳%, ۶۶%, and ۲۷%, respectively. Patients showing clinically compl ete responses post neoadjuvant chemotherapy were ۴, partial responses were ۲۱, stable disease was ۳, and progressive disease was ۲. A pathological partial response was achieved in ۹۳% of patients Conclusion: Neoadjuvant chemotherapy in locally advanced breast cancer not only downstages the disease but increases the scope of operability and thus makes it possible to resect the disease with a tumour free margin in most cases.

Keywords:

Locally advanced breast cancer (LABC) , Neoadjuvant chemotherapy (NACT)