scholarly journals Local Recurrence after Breast-Conserving Surgery and Mastectomy Following Neoadjuvant Chemotherapy for Locally Advanced Breast Cancer - a Meta-Analysis

Breast Care ◽  
2016 ◽  
Vol 11 (5) ◽  
pp. 345-351 ◽  
Author(s):  
Xiaodong Zhou ◽  
Yujie Li
Keyword(s):  
Breast Cancer ◽  
Local Recurrence ◽  
Neoadjuvant Chemotherapy ◽  
Locally Advanced Breast Cancer ◽  
Meta Analysis ◽  
Locally Advanced ◽  
Breast Conserving Surgery ◽  
Recurrence Rates ◽  
Significant Difference ◽  
Mastectomy Group

Background: Breast-conserving surgery (BCS) in patients with large tumors shrunk by neoadjuvant chemotherapy (NCT) remains controversial. We conducted a meta-analysis to evaluate the local recurrence rates in locally advanced breast cancer (LABC) patients receiving NCT comparing BCS with mastectomy. Methods: Pubmed, Web of Knowledge, and Ovid's database were searched for studies concerning treatment for LABC from January 2000 to June 2015. A meta-analysis was performed to compare the recurrence rates of patients receiving BCS versus mastectomy following NCT. Results: 8 trials with a total of 3,215 patients were analyzed. The prevalence of local recurrence was 9.2% in the BCS group versus 8.3% in the mastectomy group without significant difference (odds ratio (OR) 1.07, 95% confidence interval (CI) 0.28-1.48; p = 0.66). The 5-year local recurrence-free survival (LRFS) rate was lower in the mastectomy group than in the BCS group, but no significant difference was found between the 2 groups (OR 1.11, 95% CI 0.61-1.99; p = 0.74). Conclusion: BCS after NCT is safe in terms of local recurrence and LRFS in LABC women. Shrinking tumors with NCT provides the opportunity to apply BCS with no detriment to outcome.

Neoadjuvant chemotherapy in locally advanced breast cancer.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e11034-e11034
Author(s):  
Sami sahnoun Soraya
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Advanced Breast Cancer ◽  
Locally Advanced Breast Cancer ◽  
Locally Advanced ◽  
Molecular Classification ◽  
Advanced Breast ◽  
Her2 Positive ◽  
Significant Difference ◽  
Er Status

e11034 Background: Neoadjuvant chemotherapy(NAC)is one of the treatment options for locally advanced breast cancer. In this study, we evaluated the efficacy and safety of 4 cycles of NAC doxorubicine,docetaxel and cyclophosphamide(TAC),correlation between the response to NAC and molecular classification sub-groups and between the pCR and the time to progression(TTP). Methods: This is a prospective study from January 2005 to December 2008.110 pts with locally advanced breast cancer stage III.All pts have received 4 cycles of NAC based on docetaxel 75 mg/m², doxorubicine 50 mg/m² and cyclophosphamide 500 mg/m² every 3 weeks, followed by surgery.101 pts were assessed, since 9 of them have progressed on treatment and came out of the study. Pts were stratified according to age, menopausal status, histopathological analysis (luminal tumors(ER-positive and HER2-negative), triple-negative tumors (TN)and HER2-positive tumors), response to the treatment and survival. The median follow up of patients was 39 months. The statistical study was done using SPSS 17. Results: The median age was 41(23–65).30% of pts were younger than 35 and 80% were premenopausal. 55% luminal tumors(56 pts), 33% HER2 positive(33 pts) and 12 % TN(12 pts).CRR was estimated at 89%(37% of CR and 63% of PR).There were 23, 7% of pCR according to Chevallier’s classification. In luminal, TN and HER2-positive pCR rates were 16%(9 of 56), 66,6%(8 of 12), and 21,2%(7 of 33) respectively. Multivariate analysis showed that the ER status was the only significant predictor of pCR(P = 0.025).HER2 status was not significantly associated with pCR(P= 0,423).TTP was 50 months. In luminal tumors, TN and HER2-positive tumors the TTP was respectively 59, 52 and 49 months. There was not a significant difference in TTP between the pCR(51 months) and the non-pCR group(44 months)(CI 95, p= 0.109).Grade III/IV toxicity included neutropenia(22%), febrile neutropenia(6,5%), mucositis(13%), and diarrhea(4%). Conclusions: Breast cancer occurs in young women in Algeria. In this study, neoadjuvant TAC was effective and well tolerated. The ER status was the only significant predictor of pCR. The molecular classification group with the highest percentage of pCR was the TN group. pCR was not associated with a better prognosis.

scholarly journals Utility of FDG-PET/CT in the Evaluation of the Response of Locally Advanced Breast Cancer to Neoadjuvant Chemotherapy

2014 ◽  
Vol 99 (4) ◽  
pp. 309-318 ◽  
Author(s):  
Kei Ogino ◽  
Masanobu Nakajima ◽  
Miyako Kakuta ◽  
Mitsuhiro Hayashi ◽  
Satoru Yamaguchi ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Fdg Pet ◽  
Locally Advanced Breast Cancer ◽  
Locally Advanced ◽  
Reduction Rate ◽  
Standardized Uptake Value ◽  
Pet Ct ◽  
Significant Difference ◽  
Fdg Pet Ct

Abstract Neoadjuvant chemotherapy (NAC) is effective in down-staging a primary tumor before surgery, and quick differentiation between responders to NAC and nonresponders is needed. We investigated the utility of [18F]fluorodeoxyglucose positron emission tomography (FDG-PET) and computed tomography (CT) in evaluating the therapeutic effectiveness of NAC. We investigated 25 patients who underwent NAC for stage II and III noninflammatory breast cancer. FDG-PET/CT was undertaken before and after NAC to determine the maximum standardized uptake value (SUVmax) reduction rate. Findings were compared with postoperative histopathologic evaluation of therapeutic response. It was not possible to accurately assess tumor response to NAC using CT. However, using the SUVmax reduction rate, we noted a significant difference (P = 0.0420) between patients who were responsive and nonresponsive to NAC. The sensitivity and specificity were as high as 83.3% and 78.9%, respectively. This study demonstrated that FDG-PET/CT can differentiate responders from nonresponders. This improves patient management by avoiding unnecessary chemotherapy.

scholarly journals Effects of Neoadjuvant Fluorouracyl-Adriamycin- Cytoxan (FAC) Chemotherapy Response to CD4 + Serum Levels In Breast Cancer

2018 ◽  
Vol 1 (1) ◽  
pp. 1-9
Author(s):  
Ade Permana ◽  
Benny Kusuma ◽  
Nur Qodir ◽  
Legiran
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Advanced Breast Cancer ◽  
Locally Advanced Breast Cancer ◽  
Locally Advanced ◽  
Advanced Breast ◽  
Chemotherapy Response ◽  
Breast Cancer Chemotherapy ◽  
Significant Difference ◽  
Before And After

Introduction. CD4+ T-helper has an important role in immune system modulation especially to maintain long-term anti tumor effect. CD4+ also serves to activate CD8+ for destroyed the tumor cells. It was expected there were role of immunity on tumor growth and response of breast cancer chemotherapy to CD4+ levels serum. Furthermore, this study was aimed to investigate the effects of neoadjuvant chemotherapy on CD4+ levels in patients with locally advanced breast cancer at General Hospital Dr. Mohammad Hoesin Palembang. Method. This study was a non-comparable clinical trial by looking at serum CD4+ levels in patients with locally advanced breast cancer before and after neoadjuvant chemotherapy.   Results. Of the 30 subjects the subject age ranged from 33-66 years with an average of 45 years. There were 17 patients with contraception history (56.7%), 13 patients with family history of breast cancer (43.3%). From this study, it was obtained 23 patients with good chemotherapy response (76.7%) and there were 7 patients who had poor chemotherapy response after neoadjuvan chemotherapy (23.3%). Paired t-test analysis showed that there was a significant difference in mean CD4+ count before and after neoadjuvan chemotherapy. At the CD4+ level before chemotherapy 775.55 had a sensitivity of 60% and a specificity of 57% (cut of point). While CD4+ levels after chemotherapy 470.85 with sensitivity of 60% and specificity of 57%.   Conclusion. CD4+ pre-chemotherapy examination had a sensitivity score of 60% and a specificity of 57% in predicting neoadjuvant chemotherapy response.    

Đánh giá kết quả điều trị tân bổ trợ ung thư vú tại Bệnh viện Ung bướu Đà Nẵng

2020 ◽  
Author(s):  
Tinh Bui Thanh
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Triple Negative ◽  
Ductal Carcinoma ◽  
Locally Advanced Breast Cancer ◽  
Locally Advanced ◽  
Breast Conserving Surgery ◽  
Lymph Node Biopsy ◽  
Her2 Status ◽  
Breast Cancer Patients

Background: Neoadjuvant chemotherapy for breast cancer was used to downstaging tumours to facilitate breast-conserving surgery. Methods: A descriptive retrospective study of 93 breast cancer patients at Da Nang Oncology Hospital from January 2017 to December 2019. Patients diagnosed with locally advanced breast cancer cT2-4N0- 3M0. Exclude cases of Ductal carcinoma in situ from breast or previously treated. Results: an average age of 48, an average tumor size of 6.0 cm, the majority were Invasive ductal carcinoma (97.8%) and grade 2 ( 85.6%). Hormon receptor positive in 57%, HER-2 positive in 38.7% and 18.3% triple negative Breast cancer. The combination chemotherapy regimen Anthacycline and Taxane accounted for 94.7%, Trastuzumab-based regimen accounted for 25%. There was 8.3% progression of disease during neoadjuvant chemotherapy. About Surgery: Breast- conserving surgery in 20.5%, Breast reconstruction in 6.8%, Mastectomy in 71.6%, Sentinel lymph node biopsy in 4.3%. Her2 status was significantly different between the groups with and without pCR.. Endocrine receptors are negative, Ki67 is high, and Triple negative has a higher rate of pCR but not statistically significant. Conclusion: Neoadjuvant chemotherapy helps to downstaging tumours to facilitate breast-conserving surgery. Her2 status is correlated with the rate of complete pathological response (pCR).

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