Neo-adjuvant chemotherapy and the recurrence of breast cancer in a tertiary care rural hospital of West Bengal, India

Authors

  • Sanhita Mukherjee Department of Physiology, Calcutta National Medical College, Kolkata, India
  • Bishan Basu Department of Radiotherapy, Calcutta National Medical College, Kolkata, India
  • Nilay Mandal Department of General Surgery, B.S. Medical College, Bankura, West Bengal, India
  • Diptakanti Mukhopadhyay Department of Community Medicine, College of Medicine & Sagar Dutta Hospital, Kolkata, India
  • Biplab Kumar Biswas Department of Pathology, B.S. Medical College, Bankura, West Bengal, India
  • Bidyut Mandal Department of Radiotherapy, Calcutta National Medical College, Kolkata, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20164215

Keywords:

ACT, Breast cancer, NACT, Recurrence

Abstract

Background: Prior studies have shown long-term outcome of Neo-Adjuvant Chemotherapy (NACT) for locally advanced breast carcinoma. The purpose of the current study was to analyse the number and pattern of breast cancer recurrence at a rural hospital of West Bengal, India. The study also tried to evaluate the type of therapy received by the recurrent patients during their primary presentation and compare the disease free survival rate of the patients receiving NACT and Adjuvant Chemotherapy (ACT).

Methods: A single institution (B.S. Medical College, Bankura) retrospective chart review in the year of 2011-2014 was performed. The Kaplan-Meier methods were used to calculate disease-free survival (DFS) from the date of initiation of NACT to the date of recurrence.

Results: Of 776 patients in four years (2011-2014) total numbers of breast cancer recurrent patients were 30. The Kaplan Meier survival analysis showed disease free survival of 5 years (95% confidence interval) in case of early stage breast cancer (EBC) and 2.5 years (95% CI) in locally advanced breast CA (LABC). It was 29 months (95% confidence interval [CI] 26.74-33.253) for recurrence free survival in case of patients treated with NACT and 60 months (95% confidence interval [CI] 58.13-61.86) for recurrence free survival in case of patients not treated by NACT i.e. ACT cases.

Conclusions: This study indicates multimodality Neo-Adjuvant chemotherapy helps to achieve complete pathological response in locally advance breast cancer. Despite the recurrence free survival in NACT patients is significantly low than the patients who received adjuvant chemothepapy.

References

Howlader N, Noone AM, Krapcho M, Garshell J, Neyman N, Altekruse SF, et al. SEER Cancer Statistics Review, 1975-2011, National Cancer Institute. Bethesda.

Breast Cancer-Patient Version. Available at: www.cancer.gov/ cancertopics/ types/ breast.

Breast cancer Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw. 2003;1(2):148-88.

Hortobagyi GN, Ames FC, Buzdar AU, Kau SW, McNeese MD, Paulus D, et al. Management of stage III primary breast cancer with primary chemotherapy, surgery, and radiation therapy. Cancer. 1988;62(12):2507-16

Danforth DN Jr, Lippman ME, McDonald H, Bader J, Egan E, Lampert M, et al. Vect of preoperative chemotherapy on mastectomy for locally advanced breast cancer. Am Surg. 1990;56(1):6-11.

Schwartz GF, Birchansky CA, Komarnicky LT, Mans Weld CM, Cantor RI, Biermann WA, et al. J Induction chemotherapy followed by breast conservation for locally advanced carcinoma of the breast. Cancer. 1994;73(2):362-9.

Fisher B, Brown A, Mamounas E, Wieand S, Robidoux A, Margolese RG, et al. Vect of preoperative chemotherapy on local-regional disease in women with operable breast cancer: Wndings from National Surgical Adjuvant Breast and Bowel Project B-18. J Clin Oncol. 1997;15(7):2483-93.

Van der Hage JA, van de Velde CJ, Julien JP, Tubiana-Hulin M, Vandervelden C, Duchateau L. Preoperative chemotherapy in primary operable breast cancer: results from the European Organization for Research and Treatment of Cancer trial 10902. J Clin Oncol. 2001;19(22):4224-37.

Semiglazov V, Eiermann W, Zambetti M, Manikhas A, Bozhok A, Lluch A, et al. Surgery following neoadjuvant therapy in patients with HER2-positive locally advanced or inXammatory breast cancer participating in the NeOAdjuvant Herceptin (NOAH) study. Eur J Surg Oncol. 2011;37(10):856-63.

Angelucci D, Tinari N, Grassadonia A, Cianchetti E, Ausili-Cefaro G, Iezzi L et al. Long-term outcome of neo-adjuvant systemic therapy for locally advanced breast cancer in routine clinical practice. J Cancer Res Clin Oncol. 2013;139:269-80.

Kuerer HM, Newman LA, Smith TL, Ames FC, Hunt KK, Kapil Dhingra, et al. Clinical Course of Breast Cancer Patients With Complete Pathologic Primary Tumor and Axillary Lymph Node Response to Doxorubicin-Based Neoadjuvant Chemotherapy. J Clin Oncol. 1999;17:460-9.

Arrazin D, Le MG, Arriagada R. Ten-year results of a randomized trial comparing a conservative treatment to mastectomy in early breast cancer. Radiother Oncol. 1989;14:177-84.

Blichert-Toft M, Rose C, Andersen JA. Danish randomized trial comparing breast conservation therapy with mastectomy: six years of lifetable analysis. In: Consensus development conference on the treatment of early-stage breast cancer. J Nat Can Inst mono. 1992:19-25.

Veronesi U1, Salvadori B, Luini A, Greco M, Saccozzi R, del Vecchio M, et al. Breast conservation is a safe method in patients with small cancer of the breast: long-term results of three randomised trials on 1,973 patients. Eur J Cancer. 1995;31A:1574-9.

Fisher B, Anderson S, Redmond CK, Wolmark N, Wickerham DL, Cronin WM. Reanalysis and results after 12 years of follow-up in a randomized clinical trial comparing total mastectomy with lumpectomy with or without irradiation in the treatment of breast cancer. N Engl J Med. 1995;333:1456-61.

van Dongen JA1, Voogd AC, Fentiman IS, Legrand C, Sylvester RJ, Tong D, et al. Long-term results of a randomized trial comparing breast-conserving therapy with mastectomy: European Organization for Research and Treatment of Cancer 10801 trial. J Natl Cancer Inst. 2000;92:1143-50.

Early Breast Cancer Trialists’ Collaborative Group. Effects of radiotherapy and surgery in early breast cancer: an overview of the randomized trials. N Engl J Med. 1995;333:1444-55.

Bishop JD, Killelea BK, Chagpar AB, Horowitz NR, Lannin DR. Smoking and Breast Cancer Recurrence after Breast Conservation Therapy. Int J Breast Cancer. 2014, Article ID 327081,

Cance WG, Carey LA, Calvo BF, Sartor C, Sawyer L, Moore DT, et al. Long-Term Outcome of Neoadjuvant Therapy for Locally Advanced Breast Carcinoma. Ann Surgery. 2002;236(6):295-303.

Kuroi K, Masakazu T, Ohno S, Nakamura S, Iwata H, Masuda N, et al. Comparison of different definitions of pathologic complete response in operable breast cancer: a pooled analysis of three prospective neoadjuvant studies of JBCRG. Breast Cancer. 2015;22(6):586-95.

Ju NR, Jeffe DB, Keune J, Aft R. Patient and tumor characteristics associated with breast cancer recurrence after complete pathological response to neoadjuvant chemotherapy. Breast Cancer Res Treat. 2013;137(1):195-201.

Levy A, Borget I, Bahri M, Arnedos M, Rivin E, Vielh P, et al. Loco-regional Control After Neo-adjuvant Chemotherapy and Conservative Treatment for Locally Advanced Breast Cancer Patients. Breast J. 2014;20(4):381-7.

Newman LA. Management of patients with locally advanced breast cancer. Curr Oncol Rep. 2004;6(1):53-61.

Hung WK, Lau Y, Chan CM, Yip AW. Experience of neoadjuvant chemotherapy for breast cancer at a public hospital: retrospective study. Hong Kong Med J. 2000;6(3):265-8.

McIntosh SA, Ogston KN, Payne S, Miller ID, Sarkar TK, Hutcheon AW. Steven D Heys. Local recurrence in patients with large and locally advanced breast cancer treated with primary chemotherapy. Amer J surg. 2003;185(6):525-31.

Poole GV, Thigpen JT, Vance RB, Barber WH. Management of women who present with T4 breast cancer. Am Surg. 2004;70(8):662-6.

Cortazar P, Zhang L, Untch M, Mehta K, Costantino JP, Wolmark N, et al. Pathological complete response and long-term clinical benefit in breast cancer: the CTNeoBC pooled analysis. Lancet. 2014;pii: S0140-6736(13)62422-8.

Mauri D, Pavlidis N, Ioannidis JP. Neo-adjuvant Versus Adjuvant Systemic Treatment in Breast Cancer: A Meta-Analysis. J Nat Can Inst. 2005;97(3);188-94.

Mathiesen RR, Borgen E, Renolen A, Løkkevik E, Nesland JM, Anker G, et al. Persistence of disseminated tumor cells after neo-adjuvant treatment for locally advanced breast cancer predicts poor survival. Breast Cancer Research. 2012, 14:R117.

Toloudi M, Apostolou P, Chatziioannou M, Papasotiriou I. Correlation between Cancer Stem Cells and Circulating Tumor Cells and Their Value. Case Rep Oncol. 2011;4:44-54 .

Pattabiraman DR, Weinberg RA. Tackling the cancer stem cells — what challenges do they pose? Nature Reviews Drug Discovery. 2014;13:497-512.

American Association for Cancer Research. "Circulating tumor cells predicted recurrence, death in patients with early-stage breast cancer." ScienceDaily. Science Daily. 2010.

Han L, Shi S, Gong T, Zhang Z, Sunn X. Cancer stem cells: therapeutic implications and perspectives in cancer therapy. Acta Pharmaceutica Sinica B. 2013;3(2):65-75.

Downloads

Published

2016-12-16

How to Cite

Mukherjee, S., Basu, B., Mandal, N., Mukhopadhyay, D., Biswas, B. K., & Mandal, B. (2016). Neo-adjuvant chemotherapy and the recurrence of breast cancer in a tertiary care rural hospital of West Bengal, India. International Journal of Research in Medical Sciences, 4(12), 5387–5392. https://doi.org/10.18203/2320-6012.ijrms20164215

Issue

Section

Original Research Articles