Efficacy of neoadjuvant chemotherapy in down staging locally advanced pre-menopausal breast cancer in Eastern Nigeria: is four courses adequate?

• Published in: Journal of cancer research and therapeutics 2013-10, Vol.9 (4), p.638-643
• Main Authors: Egwuonwu, Ochonma Amobi, Anyanwu, Stanley Nnamdi, Nwofor, Alexander Maduaburochukwu
• Format: Article
• Language: English
• Subjects: Adult; Antibiotics, Antineoplastic - therapeutic use; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Breast cancer; Breast Neoplasms - drug therapy; Cancer; Care and treatment; Chemotherapy; Chemotherapy, Adjuvant; Cyclophosphamide - therapeutic use; Doxorubicin - therapeutic use; Female; Fluorouracil - therapeutic use; Health aspects; Humans; Middle Aged; Neoadjuvant Therapy; Nigeria; Patient outcomes; Postmenopausal women; Premenopause; Prognosis; Prospective Studies; Treatment Outcome
• ISSN: 0973-1482; 1998-4138
• DOI: 10.4103/0973-1482.126463

Breast cancer is the most frequent cancer among women in most part of the world and in Nigeria. Neoadjuvant chemotherapy (NAC) has been demonstrated to be a helpful strategy in the context of locally advanced breast cancer (LABC). To determine if the use of four courses of doxorubicin based neoadjuvant chemotherapeutic regimen will result in significant primary tumor down-staging. One year prospective study of premenopausal breast cancer patients presenting to the specialty breast clinic. The patients were recommended for four courses of doxorubicin based NAC and response assessed using response evaluation criteria in solid tumors (RECIST) methodology. Simple frequency and descriptive statistics were used to analyze data using SPSS statistical software. One hundred and fourteen patients presented with breast cancer. Their ages ranged from 26 to 51 years with a mean age of 42.1 years ± 7.7 years. Thirty-one patients completed the four courses of NAC. At the end of NAC, 23 (74.2%) patients had more than 30% reduction in primary tumor size and 8 (25.8%) had no response (NR). The response according to the modified RECIST methodology was 12.9% for a complete clinical response, 61.3% for partial response, and 25.8% for NR. Significant clinical response was seen in 74.2% of patients (P < 0.0001) (one sample t-test). Four courses of antracycline based NAC is effective in premenopausal patients with LABC in our environment.