Feasibility of breast conservation after neoadjuvant taxae-based chemotherapy in locally advanced breast cancer

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e11627-e11627
Author(s):  
M. A. Aboziada ◽  
M. I. El-Sayed ◽  
D. W. Maximous ◽  
M. E. Abdel-Wanis ◽  
M. M. Bakr
Keyword(s):  
Neoadjuvant Chemotherapy ◽  
Metastatic Cancer ◽  
Locally Advanced Breast Cancer ◽  
Tumour Size ◽  
Locally Advanced ◽  
Breast Conservation ◽  
Hormonal Treatment ◽  
Standard Of Care ◽  
Cancer Breast ◽  
Response To Chemotherapy

e11627 Background: Neoadjuvant chemotherapy is the standard of care of locally advanced cancer breast. Our study was aiming to evaluate the feasibility of breast conversation (BC) after neoadjuvant chemotherapy. Methods: Forty five patients had stage IIB and stage IIIA were selected to 3 cycles taxane-based neoadjuvant chemotherapy. Patient who had tumours ≤ 5cm underwent BC while patients who had tumour size >5cm underwent radical surgery. Negative margin is essential for BC. Adjuvant chemotherapy and 3-D radiotherapy ± hormonal treatment were given to all patients. Results: Thirty four patients had BC. Response to chemotherapy was the only statistically significant factor which influences the BC. Incidence of local recurrence was 5.9% for patients who had BC at a median follow up 24 months. Conclusions: Breast conservation is feasible in selected cases of locally advanced, non metastatic cancer breast. We recommend that patients who have tumour size ≤ 4cm after chemotherapy are the best candidates for BC. No significant financial relationships to disclose.

scholarly journals Size of cervical lesion in locally advanced carcinoma cervix and response to neoadjuvant chemotherapy

2019 ◽  
Vol 8 (11) ◽  
pp. 4254
Author(s):  
Neetu Ahirwar
Keyword(s):  
Neoadjuvant Chemotherapy ◽  
Tumour Size ◽  
Locally Advanced ◽  
Vascular Supply ◽  
Cervical Lesion ◽  
Carcinoma Cervix ◽  
Advanced Carcinoma ◽  
Response To Chemotherapy ◽  
Treatment Volume ◽  
Pre Treatment

Background: Recently neoadjuvant chemotherapy has started being considered for advanced stage of carcinoma cervix. Drug delivery to pelvic tumour is optimal with neoadjuvant chemotherapy since tumour vascular supply has not been damaged by any previous pelvic interference. Tumor size and parametrial involvement have been reported to be important predictor of NACT response. Objective of this study was to find out association between size of cervical lesion in locally advanced carcinoma cervix and response to neoadjuvant chemotherapy.Methods: The present prospective cohort study was carried out in the Department of Obstetrics and Gynaecology with the collaboration of Department of Radiotherapy, Chhatrapati Shahuji Maharaj Medical University Lucknow for a period of 1-year august 2010 to august 2011. 26 patients with histologically proven locally advanced carcinoma cervix were studied. In all cases Cisplatin 75 mg/m2 and paclitaxel 135 mg/m2 on day one was given at 14 days interval up to maximum of three courses. Evaluation of operability status was done two weeks after second course of chemotherapy. Those found operable were taken up for radical hysterectomy and rest were given 3rd course of chemotherapy. After two weeks of 3rd course again operability assessment was done and patient was taken up either for surgery or radiotherapy.Results: It was observed that out of 14 patients who had tumour size <4 cm, 9 (64.2%) responded completely (CR), 2 (14.2%) responded partially and 3 (21.4%) responded as SD while in 12 patients with tumour size >4 cm, 4 (33.3%) responded completely (CR) and rest 8 (66.6%) response was partial (PR).Conclusions: Response to chemotherapy was modified by pre-treatment volume of the tumour.

Efficacy of primary systemic chemotherapy regimen containing anthracyclines with/without taxanes in comparison to CMF in women with early breast cancer

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 11098-11098
Author(s):  
D. Gschwantler-Kaulich ◽  
A. Fink-Retter ◽  
T. Bachrich ◽  
M. Ledesma ◽  
E. Ruecklinger ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Tumor Regression ◽  
Locally Advanced Breast Cancer ◽  
Locally Advanced ◽  
Breast Conservation ◽  
Tumor Diameter ◽  
Breast Cancer Patients ◽  
Multifocal Disease ◽  
Anthracycline Dose

11098 Background: Neoadjuvant chemotherapy is the treatment of choice for locally-advanced breast cancer and leads to down staging and improved BCT rates. While its efficacy is well established, considerably less is known about the most effective regimen. Methods: We have performed a retrospective analysis of 132 breast cancer patients who had undergone neoadjuvant chemotherapy at our institution. Patients had either received a) anthracyclines (“A”, n=35), b) anthracyclines and taxanes (“AT”, n=55), or c) neither of the two compounds (“NoA/T”, n=42). Clinical response, pathological response and survival were evaluated in each arm. Results: While all three regimen resulted in significant tumor regression, AT was most effective with a mean tumor shrinkage of 39% (ultrasound) and 41% (mammography) (Kruskal-Wallis, p=0.004, and p=0.027). Breast conservation was achieved in 75% by AT, in 49% by A, and in 19% by NoA/T (Kruskal-Wallis, p<0.001). The treatment groups did not differ in respect to pCR (χ2-test, p=0.068), although higher cumulative anthracycline doses were predictive of pCR in multivariate analyses (p=0.022). While the mammographic and not the ultrasound-determined tumor diameter determined whether a woman underwent BCT, only an ultrasound-determined size reduction was predictive for DFS and OS (log rank, p=0.0093, and p=0.044, respectively). Other parameters that affected BCT rates were age (p= 0.003), year of diagnosis (p=<0.001), presence of multifocal disease (p= 0.032) and the cumulative anthracycline dose (p= <0.001). Conclusions: While the combination of anthracyclines and taxanes is most effective in achieving clinical remission and BCT, the cumulative anthracycline dose appears most important for achieving pCR. No significant financial relationships to disclose.

scholarly journals Young Women with Locally Advanced Breast Cancer Who Achieve Breast Conservation after Neoadjuvant Chemotherapy Have a Low Local Recurrence Rate

2011 ◽  
Vol 77 (7) ◽  
pp. 850-855 ◽  
Author(s):  
Raeshell S. Sweeting ◽  
Nancy Klauber-Demore ◽  
Michael O. Meyers ◽  
Allison M. Deal ◽  
Emily M. Burrows ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Young Women ◽  
Locally Advanced Breast Cancer ◽  
Locally Advanced ◽  
Breast Conservation ◽  
Disease Free Survival ◽  
Free Survival ◽  
Ajcc Stage ◽  
Disease Free

Women with locally advanced breast cancer (LABC) who are breast conservation (BCT) candidates after neoadjuvant chemotherapy have the best long-term outcome and low local-regional recurrence (LRR) rates. However, young women are thought to have a higher risk of LRR based on historical data. This study sought to evaluate LRR rates in young women who undergo BCT after neoadjuvant chemotherapy. We identified 122 women aged 45 years or younger with American Joint Committee on Cancer (AJCC) Stage II to III breast cancer, excluding T4d, treated with neoadjuvant chemotherapy from 1991 to 2007 from a prospective, Institutional Review Board-approved, single-institution database. Data were analyzed using Fisher eExact test, Wilcoxon tests, and the Kaplan-Meier method. Median follow-up was 6.4 years. Fifty-four (44%) patients had BCT and 68 (56%) mastectomy. Forty-six per cent were estrogen receptor-positivity and 28 per cent overexpressed Her2. Mean pretreatment T size was 5.6 cm in the BCT group and 6.7 cm in the mastectomy group ( P = 0.04). LRR rates were no different after BCT compared with mastectomy (13 vs 18%, P = 0.6). Higher posttreatment N stage ( P < 0.001) and AJCC stage ( P = 0.008) were associated with LRR but not pretreatment staging. Disease-free survival was better for patients achieving BCT, with 5-year disease-free survival rates of 82 per cent (95% CI, 69 to 90%) compared with 58 per cent (95% CI, 45 to 69%) for mastectomy ( P = 0.03). Young women with LABC who undergo BCT after neoadjuvant chemotherapy appear to have similar LRR rates compared with those with mastectomy. This suggests that neoadjuvant chemotherapy may identify young women for whom BCT may have an acceptable risk of LRR.

scholarly journals Prospective Assessment of Systemic MicroRNAs as Markers of Response to Neoadjuvant Chemotherapy in Breast Cancer

Cancers ◽  
2020 ◽  
Vol 12 (7) ◽  
pp. 1820
Author(s):  
Andrew McGuire ◽  
Maire-Caitlin Casey ◽  
Ronan M. Waldron ◽  
Helen Heneghan ◽  
Olga Kalinina ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Locally Advanced Breast Cancer ◽  
Locally Advanced ◽  
Pathologic Complete Response ◽  
Standard Of Care ◽  
Complete Response ◽  
Circulating Microrna ◽  
Breast Cancer Patients ◽  
Prospective Assessment

Neoadjuvant chemotherapy (NACT) is used in locally advanced breast cancer to reduce tumour burden prior to surgical resection. However, only a subset of NACT treated patients will respond to treatment or achieve a pathologic complete response (pCR). This multicenter, prospective study (CTRIAL-IE (ICORG) 10-11 study) evaluated circulating microRNA as novel non-invasive prognostic biomarkers of NACT response in breast cancer. Selected circulating microRNAs (Let-7a, miR-21, miR-145, miR-155, miR-195) were quantified from patients undergoing standard of care NACT treatment (n = 114) from whole blood at collected at diagnosis, and the association with NACT response and clinicopathological features evaluated. NACT responders had significantly lower levels of miR-21 (p = 0.036) and miR-195 (p = 0.017), compared to non-responders. Evaluating all breast cancer cases miR-21 was found to be an independent predictor of response (OR 0.538, 95% CI 0.308–0.943, p < 0.05). Luminal cancer NACT responders were found to have significantly decreased levels of miR-145 (p = 0.033) and miR-21 (p = 0.048), compared to non-responders. This study demonstrates the prognostic ability of miR-21, miR-195 and miR-145 as circulating biomarkers stratifying breast cancer patients by NACT response, identifying patients that will derive the maximum benefit from chemotherapy.

scholarly journals Clinical, radiological and pathological evaluation of residual disease in women receiving neoadjuvant chemotherapy for locally advance carcinoma breast

2018 ◽  
Vol 5 (2) ◽  
pp. 531
Author(s):  
Mayank Mishra ◽  
Puspendra Singh ◽  
Alok Tripathi
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Residual Disease ◽  
Locally Advanced Breast Cancer ◽  
Locally Advanced ◽  
Incidence Rates ◽  
Response To Chemotherapy ◽  
Pathological Evaluation ◽  
After Cancer ◽  
Adjusted Incidence

Background: Egyptians were first to note this disease, 3,500 years ago and described fairly accurately in George Ebers papyri. This disease occurs almost entirely in women, but men can get it, too. Breast cancer is most common among women worldwide. In India, its second after cancer cervix. Its incidence outranks all other cancers in women >35 years of age. Age adjusted incidence rates vary from 9.7- 28.2/100,000. The treatment of locally advanced breast cancer has considerably changed and now includes a multidisciplinary approach, which is directed both to locoregional control and destruction of distant micro-metastasis. Neoadjuvant therapy causes a reduction in size of primary tumor allowing more conservative surgical approach without any increase in locoregional recurrence rate. Limitations of clinical methods for assessment of response to neoadjuvant chemotherapy have now incorporated by imaging and pathological method.Methods: In present study author assess LABC clinically, radiologically and pathologically by mammography USG, FNAC and histopathologic examination, pre- and post-neoadjuvant chemotherapy and evaluate response to chemotherapy, reduction of tumor volume and prior assessment of the patient’s prognosis.Results: Present study shown USG is more accurate in assessing residual disease in post neoadjuvant chemotherapy in defining the real extent of residual disease and also superior in term of detecting complete pathological response.Conclusions: A multimodal assessment of response of neoadjuvant chemotherapy is needed to direct optimal surgical treatment with acceptable cosmesis.

MRI of the breast before and after primary systemic therapy correlates with histopathological tumor size in patients with locally advanced breast cancer (LABC)

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 507-507
Author(s):  
V. Russu ◽  
B. Lex ◽  
M. Popovich ◽  
K. Pfaffenberger ◽  
H. Volkholz ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Advanced Breast Cancer ◽  
Systemic Therapy ◽  
Locally Advanced Breast Cancer ◽  
Tumour Size ◽  
Locally Advanced ◽  
Tumour Response ◽  
Primary Systemic Therapy ◽  
Response To Chemotherapy ◽  
Before And After

507 Background: Primary systemic therapy (PST) is a widely accepted preoperative treatment for patients with locally advanced breast cancer (LABC). Different authors beside our study-group showed that MRI is a sensitive method in describing the remaining size of an invasive breast lesion after PST. The established methods for measuring the size of lesions and monitoring the tumour-response to chemotherapy are clinical palpation, mammography and ultrasound, but specificity of these methods is unsatisfactory. Our prospective data is to clarify the accuracy of MRI in monitoring the tumour-response to PST is presented. Methods: 207 female patients (range of age: 26a- 78a) with LABC (cT2 – cT4) were examined with dynamic contrast enhanced MRI after PST. 173 (84%) patients have had MRI examination before and after PST. 145 (70%) patients had a ductal-invasive, 48 (23%) patients a lobular-invasive carcinoma. 70 (34%) patients were treated with sequential anthracyclin- and taxan-based chemotherapy and 137(66%) with only anthracyclin based chemotherapy. 51% patients were premenopausal. 70% had an ER-positive tumour. The measure of tumour-response to PST was graded in partial response (PR: >50% of tumour reduction mm2), no change (NC: <50%) and complete response (CR: no evidence of residual tumour-cells). Results: Comparing tumour-size measured by MRI before and after PST 119 (69 %) of the patients had PR and 25 (14.5%) CR. The histological tumour- size after PST strongly correlated with the size measured by MRI r = 0,758 (pâ€1 0.001). Analyzing the tumour-types ductal-invasive carcinomas were significant (p<0.001) better to monitor than lobular-invasive types (r=0.824/r=0.210). Conclusions: preoperative MRI seems to be a helpful tool in estimating the efficacy of the tumour-response to chemotherapy and for the operative planning in the patients with LABC after PST, especially for ductal-invasive tumours. No significant financial relationships to disclose.

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