scholarly journals A clinical study of outcome of neoadjuvant chemotherapy in 30 cases of locally advanced breast carcinoma

2019 ◽  
Vol 6 (12) ◽  
pp. 4383
Author(s):  
Shwetal Ravindrabhai Sonvane ◽  
Mukesh Pancholi ◽  
Akhil Sharma
Keyword(s):  
Breast Cancer ◽  
Breast Carcinoma ◽  
Neoadjuvant Chemotherapy ◽  
Advanced Breast Cancer ◽  
Clinical Response ◽  
Locally Advanced Breast Cancer ◽  
Locally Advanced ◽  
Advanced Breast ◽  
Axillary Lymph ◽  
Management Problem

Background: Locally advanced breast cancer presents with a difficult management problem. It remains a challenge to achieve local and distant control of locally advanced breast cancer. Over the last decade preoperative/ neoadjuvant chemotherapy has emerged as the standard of care for these patients. Successful reduction in the size of the tumor is associated with increased rate of operability. The objective of this study is to observe the response of neoadjuvant chemotherapy in locally advanced breast carcinoma in form of outcome and complications. The outcome is measured as down staging or downgrading of tumor, results of surgery and its complications, disease free survival and recurrence.Methods: This is the observational prospective study of consecutive 30 cases of locally advanced breast cancer admitted in department of general surgery during a period from May 2017 to August 2018 at new civil hospital, Surat. Neo adjuvant chemotherapy were given every three weekly and the response of therapy calculated in form of reduction in the size of tumor or getting the margin free from skin or pectoral muscles or reduction in the axillary lymph node mass.Results: In this study about 93% of cases responded to neoadjuvant chemotherapy with 10% of cases shows complete clinical response where tumor becomes completely free from skin or pectoral muscles or negative axillary lymph nodes.Conclusions: With the evidence from the literature and study conducted earlier, our observations of clinical response of neoadjuvant chemotherapy in patients with locally advanced breast cancer had corroborative evidence.

scholarly journals Correlation between Serum Interleukin-6 Levels and Clinical Response to Anthracycline-Based Neoadjuvant Chemotherapy Regimen in Locally Advanced Breast Cancer Patients

2021 ◽  
Vol 8 (11) ◽  
pp. 1-9
Author(s):  
Fahriansyah Mega Pratama ◽  
Husnul Ghaib ◽  
Iskandar Ali
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Advanced Breast Cancer ◽  
Clinical Response ◽  
Interleukin 6 ◽  
Positive Response ◽  
Locally Advanced Breast Cancer ◽  
Locally Advanced ◽  
Advanced Breast ◽  
Level Group

Background: Neoadjuvant chemotherapy is the initial therapy and the main pillar of treatment for locally advanced breast cancer (LABC). Currently, there is marker that widely accepted as a predictive factor for chemotherapy response in LABC. Elevated serum interleukin-6 (IL-6) levels and tumor sites have been proposed as prognostic markers for breast cancer. In this study, we aimed to examine the association between serum IL-6 levels with clinical response after the administration of neoadjuvant chemotherapy. Methods: This study is an observational analytic study with a cohort prospective character to determine the relationship between IL-6 serum levels and clinical response to anthracycline-based neoadjuvant chemotherapy in locally advanced breast cancer (LABC) patients at Dr. Soetomo General Hospital during April 2021 to September 2021 with a total sample of 38 patients. Results: Fourteen patients (77.8%) had a positive response in the low IL-6 level group and 4 patients (22.2%) had a negative response. In high IL-6 level group, 4 patients (40%) had a positive response and 16 patients (80%) had a negative response. The cut off of 15.495 pg/mL was used as cut off value for IL-6 to predict the clinical response to chemotherapy. The sensitivity, specificity, PPV, NPV, and accuracy of IL-6 to predict the clinical response after chemotherapy were 80.0%, 77.8%, 80.0%, 77.8%, and 78.9%, respectively. Conclusion: There is a relationship between serum IL-6 levels and clinical response to anthracycline-based neoadjuvant chemotherapy regimens in locally advanced breast cancer (LABC) patients. Keywords: interleukin-6, clinical response, locally advanced breast cancer.

scholarly journals Efficacy of Combination Neoadjuvant Chemotherapy and Regional Inductive Moderate Hyperthermia in the Treatment of Patients With Locally Advanced Breast Cancer

2020 ◽  
Vol 19 ◽  
pp. 153303382096359
Author(s):  
Anton Loboda ◽  
Ivan Smolanka Sr ◽  
Valerii E. Orel ◽  
Liubov Syvak ◽  
Tetiana Golovko ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Advanced Breast Cancer ◽  
Locally Advanced Breast Cancer ◽  
Objective Response ◽  
Locally Advanced ◽  
Advanced Breast ◽  
Control Group ◽  
Axillary Lymph ◽  
Experimental Group

Purpose: To evaluate the efficacy of neoadjuvant chemotherapy in combination with regional inductive moderate hyperthermia for patients with locally advanced breast cancer. Patients and Methods: 200 patients with stage IIB-IIIA breast cancer received neoadjuvant chemotherapy (control group, n = 97) or chemotherapy combined with hyperthermia (experimental group, n = 103). Inductive hyperthermia was set at 27.12 ± 0.16 MHz and the 50 W output power. Results: Thermal and color Doppler ultrasound imaging demonstrated that hyperthermia increased the surface temperature on the breasts to < 4°С while the mean values for systolic blood flow were 3.5 times as high as those prior to treatment. Assessment of tumor size and response found a (31.24 ± 3.85)% reduction in the size of the primary tumor in patients receiving chemotherapy + hyperthermia, while chemotherapy alone showed a (22.95 ± 3.61)% decrease on average (p = 0.034). The rate of objective response increased by 15.9% in the experimental group (р = 0.034) compared with the control group. The patients in the experimental group also had axillary lymph node regression of 14.17% greater than in the control group (p = 0.011). Moreover, the combination treatment allowed to increase the proportion of women eligible for breast-conserving and reconstructive surgery by 13.63% in the experimental group. The viable tumor volume was lower in patients receiving neoadjuvant chemotherapy + hyperthermia (24.4 ± 0.2)% compared with those given chemotherapy alone (30.4 ± 0.25)%. The 10-year overall survival rates were higher (log-rank: p = 0.009) in breast cancer patients who underwent chemotherapy combined with hyperthermia than in patients receiving chemotherapy only. Conclusion: The combination neoadjuvant chemotherapy and the technology of regional inductive moderate hyperthermia improved the efficacy of treatment for patients with locally advanced breast cancer staged IIB-IIIA.

Factors that predict pathologic complete response in patients receiving neoadjuvant chemotherapy for locally advanced breast cancer.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e11588-e11588
Author(s):  
Narendra Hulikal ◽  
Joseph Thomas ◽  
Donald J. Fernandes ◽  
Satadru Ray
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Advanced Breast Cancer ◽  
Clinical Response ◽  
Preoperative Chemotherapy ◽  
Hormone Receptor ◽  
Locally Advanced Breast Cancer ◽  
Locally Advanced ◽  
Complete Response ◽  
Advanced Breast

e11588 Background: Locally advanced breast cancer (LABC) accounts for 30-60% of all breast cancer patients presenting to the public hospitals in India. The neoadjuvant chemotherapy is reported to achieve a pathological complete response (pCR) rate of 35-60% depending on the receptor subsets and the chemotherapeutic drugs employed. The patients who achieve a pCR are expected to do better in terms of progression free survival. Hence we reviewed our data base to know pCR rates, to compare pCR rates among various receptor subgroups, and to determine the factors which predict pCR. Methods: All patients with LABC (defined as Stage III, AJCC, 7th edition, 2010) and agreed by the hospital tumor board to receive preoperative chemotherapy were included. At each visit, clinical response was assessed according to RECIST criteria. Re-staging work up and mammography were done prior to surgery. Results: Total 84 patients received preoperative chemotherapy. Most common regimen used was 4 courses of AC followed by 4 courses of 3 weekly paclitaxel. Two patients developed systemic metastasis during chemotherapy and were not considered for surgery. Median age was 46 years (ranged from 28 to 66), 46 patients were premenopausal, and 43 % of the tumors were hormone receptor negative. Her 2nu amplification defined as immunohistochemistry 3 + or FISH positive was seen in 27% of patients. Thirty nine patients were stage IIIB, 38 were III A and 5 were IIIC. Total 72 patients completed full course of chemotherapy before surgery. Clinical response was complete in 26, partial in 52, 3 had local progression, one stable and two patient developed distant metastasis (not considered for surgery). Forty eight patients underwent modified radical mastectomy and breast could be conserved in 34 patients. The pCR rate was 36%. Of all the factors (cT status, hormone receptor status, menopausal status, age) cT status was found to be statistically significant factor to predict pCR (p<0.005). Conclusions: Overall pCR rate in the study was 36%, maximum response was noted in ER/PR negative, Her 2nu positive subset. Only factor which was found to be associated with pCR on univariate analysis was cT size.

scholarly journals The Prognostic Impact of Body Composition for Locally Advanced Breast Cancer Patients Who Received Neoadjuvant Chemotherapy

Cancers ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 608
Author(s):  
Toshiaki Iwase ◽  
Aaroh Parikh ◽  
Seyedeh S. Dibaj ◽  
Yu Shen ◽  
Tushaar Vishal Shrimanker ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Body Composition ◽  
Adipose Tissue ◽  
Neoadjuvant Chemotherapy ◽  
Advanced Breast Cancer ◽  
Locally Advanced Breast Cancer ◽  
Locally Advanced ◽  
Pathologic Complete Response ◽  
Complete Response ◽  
Advanced Breast

Our previous study indicated that a high amount of visceral adipose tissue was associated with poor survival outcomes in patients with early breast cancer who received neoadjuvant chemotherapy. However, inconsistency was observed in the prognostic role of body composition in breast cancer treatment outcomes. In the present study, we aimed to validate our previous research by performing a comprehensive body composition analysis in patients with a standardized clinical background. We included 198 patients with stage III breast cancer who underwent neoadjuvant chemotherapy between January 2007 and June 2015. The impact of body composition on pathologic complete response and survival outcomes was determined. Body composition measurements had no significant effect on pathologic complete response. Survival analysis showed a low ratio of total visceral adipose tissue to subcutaneous adipose tissue (V/S ratio ≤ 34) was associated with shorter overall survival. A changepoint method determined that a V/S ratio cutoff of 34 maximized the difference in overall survival. Our study indicated the prognostic effect of body composition measurements in patients with locally advanced breast cancer compared to those with early breast cancer. Further investigation will be needed to clarify the biological mechanism underlying the association of V/S ratio with prognosis in locally advanced breast cancer.

Sign in / Sign up

Export Citation Format

Share Document