Effectiveness of Anthracycline Based Neoadjuvant Chemotherapy in Tumour Size Reduction in Pre-Menopausal Women with Locally Advanced Breast Cancer Effectiveness of Anthracycline Based Neoadjuvant Chemotherapy.

Abstract

Background: Neo-adjuvant chemotherapy (NAC) has been demonstrated as a helpful strategy and the standard of care in the multimodal management of locally advanced breast cancer. Objectives: This study aims to evaluate the effectiveness of anthracycline-based neoadjuvant chemotherapy in down-staging locally advanced breast cancer in pre-menopausal women. Materials and Methods: The size of the primary breast tumor was measured initially, after each course of chemotherapy, and three weeks after the 4th course of NAC. Four courses of the regimen: cyclophosphamide, doxorubicin, and 5-fluorouracil (CAF) were given every three weeks. Medication response was evaluated using a modification of the RECIST methodology. The data were analyzed using the SPSS statistical software version 23.0. (Statistical Package for Social Sciences SPSS Inc.). Results: Only 49 patients were able to complete the four courses of neoadjuvant chemotherapy. The age of the study population ranged from 24 to 54 (40.92±7.98) years. The pre-chemotherapy sizes of the breast masses ranged from 3.0-25.0 (9.70±4.33) cm. The mean size of the breast masses after 1st to 4th course were:8.26±4.13cm, 6.72±4.32cm, 6.09±4.97cm, and 5.79±5.35cm respectively. The size reduction was significant, with Spearman's correlation coefficients Sr values of 0.869, 0.667, 0.619, and 0.599 from 1st to 4th course. Nine (18.4%) of the 49 patients have achieved clinical complete response (cCR) after 4 courses of NAC. Conclusion: Neoadjuvant chemotherapy using combined cyclophosphamide, doxorubicin, and 5-fluorouracil (CAF) was found to be very effective in the management of locally advanced breast cancer in premenopausal women.