Citation:Peiris, H. H., Mudduwa, L. K. B., Thalagala, N. I., Jayatilake, K. A. P. W., Ekanayake, U., & Horadugoda, J. Predictive Factors of Breast Cancer Specific Survival of Patients Who Received Neoadjuvant Chemotherapy. GENERAL SIR JOHN KOTELAWALA DEFENCE UNIVERSITY (KDU), 79.
Date:2015-08
Abstract:
Neoadjuvant Chemotherapy (NAC) is a safe
and effective therapeutic approach for larger primary
and locally advanced breast cancer. The objective of this
study was to determine the factors predicting the survival
of breast cancer patients who received NAC and
underwent surgical treatment.This retrospective study
included all breast cancer patients who received NAC and
had sought the services of the Immunohistochemistry
Laboratory in the Faculty of Medicine, Galle from May
2006 to December 2012. Data was collected through
follow up visits, clinic and laboratory records. Degree of
down staging was estimated using clinical and
pathological stage of the tumour. Breast Cancer Specific
Survival (BCSS) and Recurrence Free Survival (RFS) rates
were estimated using Kaplan-Meier model. Cox regression model was used for multivariate analysis. This
study comprised of 164 patients. Five year BCSS of
patients who received NAC was 63% and RFS was 59%.
Only 2% had pathological complete response following
NAC. Nodal down-staging (19%) was less prevalent than
tumour down-staging (80%). Down-staging by overall
TNM group was seen in 71.4%. There was no statistically
significant difference in RFS or BCSS in terms of degree of
down-staging. In the multivariate analysis, the presence
of lympho-vascular invasion(LVI), negative progesterone
receptor(PR) status and pathological stage following NAC
were found to affect the BCSS (p<0.05) while the initial
clinical stage did not have an effect (p>0.05).This study
indicates that degree of down-staging by NAC does not
influence the RFS or BCSS. The presence of LVI, expression
of PR and the final pathological stage predict the BCSS of
patients who received NAC but not the initial clinical
stage.