Neoadjuvant chemotherapy for locally advanced breast cancer in a Malaysian tertiary hospital

Muhammad Azrif, Jalal Ibrahim, Nik Muhd. Aslan Abdullah, Voon Fong Kua, Fuad Ismail

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Introduction: Neoadjuvant chemotherapy for locally advanced breast cancer is given with the aim of shrinking the disease sufficiently for surgery. However, many clinical trials investigating neoadjuvant chemotherapy regimens were conducted for operable breast cancer. Methods and Materials: Patients with T3-4, N2 M0 breast cancer diagnosed between January 2005 and December 2008 and who received at least one cycle of neoadjuvant chemotherapy were eligible for this study. Thirty-four patients were identified from the Chemotherapy Daycare Records and their medical records were reviewed retrospectively. The neoadjuvant chemotherapy regimen administered was at the discretion of the treating oncologist. Breast tumour size and nodal status was assessed at diagnosis, at each cycle and before surgery. Results: All 34 patients had invasive ductal cancer. The median age was 52 years (range 27-69). 65% had T4 disease and 76% were clinically lymph node positive at diagnosis. The median size of the breast tumour at presentation was 80 mm (range 42-200 mm). Estrogen and progesterone receptor positivity was seen in less than 40% and HER2 positivity, by immunohistochemistry, in 27%. The majority (85%) of patients had anthracycline based chemotherapy, without taxanes. The overall response rate (clinical CR+PR) was 67.6% and pathological complete responses were apparent in two (5.9%). 17.6% of patients defaulted part of their planned treatment. Recurrent disease was seen in 44.1% and the median time to relapse was 11.3 months. The three year disease free and overall survival rates were 52.5% and 58% respectively. Conclusion: Neoadjuvant chemotherapy for locally advanced breast cancer in a Malaysian setting confers response and pCR rates comparable to published clinical trials. Patients undergoing neoadjuvant chemotherapy are at risk of defaulting part of their treatment and therefore their concerns need to be identified proactively and addressed in order to improve outcomes.

Original languageEnglish
Pages (from-to)157-162
Number of pages6
JournalAsian Pacific Journal of Cancer Prevention
Volume12
Issue number1
Publication statusPublished - 2011

Fingerprint

Tertiary Care Centers
Breast Neoplasms
Drug Therapy
Clinical Trials
Taxoids
Anthracyclines
Progesterone Receptors
Estrogen Receptors
Disease-Free Survival
Medical Records
Survival Rate
Lymph Nodes
Immunohistochemistry
Recurrence
Therapeutics
Neoplasms

Keywords

  • Locally advanced breast cancer
  • Neoadjuvant chemotherapy
  • Non-compliance

ASJC Scopus subject areas

  • Oncology
  • Cancer Research
  • Public Health, Environmental and Occupational Health
  • Epidemiology

Cite this

Neoadjuvant chemotherapy for locally advanced breast cancer in a Malaysian tertiary hospital. / Azrif, Muhammad; Ibrahim, Jalal; Abdullah, Nik Muhd. Aslan; Kua, Voon Fong; Ismail, Fuad.

In: Asian Pacific Journal of Cancer Prevention, Vol. 12, No. 1, 2011, p. 157-162.

Research output: Contribution to journalArticle

Azrif, Muhammad ; Ibrahim, Jalal ; Abdullah, Nik Muhd. Aslan ; Kua, Voon Fong ; Ismail, Fuad. / Neoadjuvant chemotherapy for locally advanced breast cancer in a Malaysian tertiary hospital. In: Asian Pacific Journal of Cancer Prevention. 2011 ; Vol. 12, No. 1. pp. 157-162.
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abstract = "Introduction: Neoadjuvant chemotherapy for locally advanced breast cancer is given with the aim of shrinking the disease sufficiently for surgery. However, many clinical trials investigating neoadjuvant chemotherapy regimens were conducted for operable breast cancer. Methods and Materials: Patients with T3-4, N2 M0 breast cancer diagnosed between January 2005 and December 2008 and who received at least one cycle of neoadjuvant chemotherapy were eligible for this study. Thirty-four patients were identified from the Chemotherapy Daycare Records and their medical records were reviewed retrospectively. The neoadjuvant chemotherapy regimen administered was at the discretion of the treating oncologist. Breast tumour size and nodal status was assessed at diagnosis, at each cycle and before surgery. Results: All 34 patients had invasive ductal cancer. The median age was 52 years (range 27-69). 65{\%} had T4 disease and 76{\%} were clinically lymph node positive at diagnosis. The median size of the breast tumour at presentation was 80 mm (range 42-200 mm). Estrogen and progesterone receptor positivity was seen in less than 40{\%} and HER2 positivity, by immunohistochemistry, in 27{\%}. The majority (85{\%}) of patients had anthracycline based chemotherapy, without taxanes. The overall response rate (clinical CR+PR) was 67.6{\%} and pathological complete responses were apparent in two (5.9{\%}). 17.6{\%} of patients defaulted part of their planned treatment. Recurrent disease was seen in 44.1{\%} and the median time to relapse was 11.3 months. The three year disease free and overall survival rates were 52.5{\%} and 58{\%} respectively. Conclusion: Neoadjuvant chemotherapy for locally advanced breast cancer in a Malaysian setting confers response and pCR rates comparable to published clinical trials. Patients undergoing neoadjuvant chemotherapy are at risk of defaulting part of their treatment and therefore their concerns need to be identified proactively and addressed in order to improve outcomes.",
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