A Study on Clinical and Pathological Responses to Neoadjuvant Chemotherapy in Breast Carcinoma

Supreeth Kumar Reddy Kunnuru,1 Manuneethimaran Thiyagarajan,1 Jovita Martin Daniel,2 Balaji Singh K1 1General Surgery Department, Sri Ramachandra Medical University, Chennai 600116, India; 2Medical Oncology Department, Sri Ramachandra Medical University, Chennai 600116, IndiaCorrespondence: Manuneet...

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Autores principales:	Kunnuru SKR, Thiyagarajan M, Martin Daniel J, Singh K B
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2020
Materias:	neo adjuvant chemotherapy ca breast predictors of nact response. clinical and pathological response to nact. Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/bf01a8d5b8274dcb93a39a710270c3e7
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spelling	oai:doaj.org-article:bf01a8d5b8274dcb93a39a710270c3e72021-12-02T11:15:40ZA Study on Clinical and Pathological Responses to Neoadjuvant Chemotherapy in Breast Carcinoma1179-1314https://doaj.org/article/bf01a8d5b8274dcb93a39a710270c3e72020-11-01T00:00:00Zhttps://www.dovepress.com/a-study-on-clinical-and-pathological-responses-to-neoadjuvant-chemothe-peer-reviewed-article-BCTThttps://doaj.org/toc/1179-1314Supreeth Kumar Reddy Kunnuru,1 Manuneethimaran Thiyagarajan,1 Jovita Martin Daniel,2 Balaji Singh K1 1General Surgery Department, Sri Ramachandra Medical University, Chennai 600116, India; 2Medical Oncology Department, Sri Ramachandra Medical University, Chennai 600116, IndiaCorrespondence: Manuneethimaran ThiyagarajanGeneral Surgery Department, Sri Ramachandra Medical University, 9036, Tower 9b, Prestige, Iyyapanthanagal, Chennai 614613, IndiaTel +91 9952044955Email profmaran@gmail.comJovita Martin Daniel Medical Oncology DepartmentSri Ramachandra Medical University, Porur, Chennai 600116, IndiaPorur Email jovimartin4@gmail.comAim and objectives: To assess the effectiveness of neo-adjuvant chemotherapy and its impact on the clinical and pathological response in locally advanced breast cancer. To compare molecular subtypes of breast cancer with response to neo-adjuvant chemotherapy.Patients and methods: This was a prospective study on patients who received neoadjuvant chemotherapy for breast carcinoma for a 3-year period. A total of 60 patients who presented with locally advanced breast cancer (LABC) were treated with neoadjuvant chemotherapy. Forty patients were treated with the 5-fluorouracil, epirubicin, and cyclophosphamide (FEC) schedule, 16 patients were treated with Adriamycin and cyclophosphamide (AC), and four patients were treated with oral cyclophosphamide, intravenous methotrexate, and fluorouracil (CMF). Taxol was added in all node-positive cases, triple negative breast cancer (TNBC), and Her 2 positive cases. The clinical response was assessed with RECIST criteria after neoadjuvant chemotherapy. The response was compared with molecular subtypes of carcinoma breast and receptor status individually.Results: A total of 60 female patients receiving primary chemotherapy for locally advanced breast malignancy were studied. The median age of the patients at the time of diagnosis was 44 years (range=24– 73). In terms of menopausal status, 25 (42%) patients were pre-menopausal and 35 (58%) patients were post-menopausal. Histological classification showed invasive ductal carcinoma in 72% of patients, invasive lobular carcinoma in 15% of patients, and other types including mixed patterns in 13% of patients. Among 60 patients, 16 patients (26.6%) had clinically complete remission (cCR), 30 patients (50%) had partial remission, eight patients (13.3%) had stable disease, and six patients (10%) had progressive disease. Following neoadjuvant chemotherapy, 46 (76.6%) patient underwent Modified radical mastectomy surgery. Target therapy was given for Her2 neu patients after surgery. Hormonal therapy was added to hormone ER PR positive cases postoperatively. Eight patients (13.3%) among this operated cases attained complete pathological response.Conclusion: Preoperative chemotherapy downstages the primary tumors and axillary metastasis in patients with locally advanced breast carcinoma. Comparison of molecular subtypes with chemotherapy response is a better way to find out the predictors of response to chemotherapy.Keywords: neoadjuvant chemotherapy, carcinoma breast, predictors of NACT response, clinical and pathological response to NACTKunnuru SKRThiyagarajan MMartin Daniel JSingh K BDove Medical Pressarticleneo adjuvant chemotherapyca breastpredictors of nact response. clinical and pathological response to nact.Neoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENBreast Cancer: Targets and Therapy, Vol Volume 12, Pp 259-266 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	neo adjuvant chemotherapy ca breast predictors of nact response. clinical and pathological response to nact. Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	neo adjuvant chemotherapy ca breast predictors of nact response. clinical and pathological response to nact. Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Kunnuru SKR Thiyagarajan M Martin Daniel J Singh K B A Study on Clinical and Pathological Responses to Neoadjuvant Chemotherapy in Breast Carcinoma
description	Supreeth Kumar Reddy Kunnuru,1 Manuneethimaran Thiyagarajan,1 Jovita Martin Daniel,2 Balaji Singh K1 1General Surgery Department, Sri Ramachandra Medical University, Chennai 600116, India; 2Medical Oncology Department, Sri Ramachandra Medical University, Chennai 600116, IndiaCorrespondence: Manuneethimaran ThiyagarajanGeneral Surgery Department, Sri Ramachandra Medical University, 9036, Tower 9b, Prestige, Iyyapanthanagal, Chennai 614613, IndiaTel +91 9952044955Email profmaran@gmail.comJovita Martin Daniel Medical Oncology DepartmentSri Ramachandra Medical University, Porur, Chennai 600116, IndiaPorur Email jovimartin4@gmail.comAim and objectives: To assess the effectiveness of neo-adjuvant chemotherapy and its impact on the clinical and pathological response in locally advanced breast cancer. To compare molecular subtypes of breast cancer with response to neo-adjuvant chemotherapy.Patients and methods: This was a prospective study on patients who received neoadjuvant chemotherapy for breast carcinoma for a 3-year period. A total of 60 patients who presented with locally advanced breast cancer (LABC) were treated with neoadjuvant chemotherapy. Forty patients were treated with the 5-fluorouracil, epirubicin, and cyclophosphamide (FEC) schedule, 16 patients were treated with Adriamycin and cyclophosphamide (AC), and four patients were treated with oral cyclophosphamide, intravenous methotrexate, and fluorouracil (CMF). Taxol was added in all node-positive cases, triple negative breast cancer (TNBC), and Her 2 positive cases. The clinical response was assessed with RECIST criteria after neoadjuvant chemotherapy. The response was compared with molecular subtypes of carcinoma breast and receptor status individually.Results: A total of 60 female patients receiving primary chemotherapy for locally advanced breast malignancy were studied. The median age of the patients at the time of diagnosis was 44 years (range=24– 73). In terms of menopausal status, 25 (42%) patients were pre-menopausal and 35 (58%) patients were post-menopausal. Histological classification showed invasive ductal carcinoma in 72% of patients, invasive lobular carcinoma in 15% of patients, and other types including mixed patterns in 13% of patients. Among 60 patients, 16 patients (26.6%) had clinically complete remission (cCR), 30 patients (50%) had partial remission, eight patients (13.3%) had stable disease, and six patients (10%) had progressive disease. Following neoadjuvant chemotherapy, 46 (76.6%) patient underwent Modified radical mastectomy surgery. Target therapy was given for Her2 neu patients after surgery. Hormonal therapy was added to hormone ER PR positive cases postoperatively. Eight patients (13.3%) among this operated cases attained complete pathological response.Conclusion: Preoperative chemotherapy downstages the primary tumors and axillary metastasis in patients with locally advanced breast carcinoma. Comparison of molecular subtypes with chemotherapy response is a better way to find out the predictors of response to chemotherapy.Keywords: neoadjuvant chemotherapy, carcinoma breast, predictors of NACT response, clinical and pathological response to NACT
format	article
author	Kunnuru SKR Thiyagarajan M Martin Daniel J Singh K B
author_facet	Kunnuru SKR Thiyagarajan M Martin Daniel J Singh K B
author_sort	Kunnuru SKR
title	A Study on Clinical and Pathological Responses to Neoadjuvant Chemotherapy in Breast Carcinoma
title_short	A Study on Clinical and Pathological Responses to Neoadjuvant Chemotherapy in Breast Carcinoma
title_full	A Study on Clinical and Pathological Responses to Neoadjuvant Chemotherapy in Breast Carcinoma
title_fullStr	A Study on Clinical and Pathological Responses to Neoadjuvant Chemotherapy in Breast Carcinoma
title_full_unstemmed	A Study on Clinical and Pathological Responses to Neoadjuvant Chemotherapy in Breast Carcinoma
title_sort	study on clinical and pathological responses to neoadjuvant chemotherapy in breast carcinoma
publisher	Dove Medical Press
publishDate	2020
url	https://doaj.org/article/bf01a8d5b8274dcb93a39a710270c3e7
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A Study on Clinical and Pathological Responses to Neoadjuvant Chemotherapy in Breast Carcinoma

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