TITLE:
Primary Surgery Compared to Post Chemotherapy Surgery for Patients with Locally Advanced Breast Cancer
AUTHORS:
Ibrahim Altedlawi AlBalawi
KEYWORDS:
Adjuvant, Breast, Cancer, Neoadjuvant, Surgery
JOURNAL NAME:
Journal of Cancer Therapy,
Vol.9 No.10,
October
8,
2018
ABSTRACT: Purpose: To compare primary surgery and surgery after
neoadjuvant chemotherapy (NCT) in locally advanced breast cancer (LABC)
patients. Methods: Between January 2011 & December 2015, 112
patients with LABC were treated at KAAH & OC-Jeddah-KSA, Of whom 42 were treated by
NCT followed by surgery either mastectomy or conservative surgery, then
adjuvant chemotherapy and radiotherapy. The rest patients (70) were treated by
primary surgery (mastectomy or conservative resection) and followed by adjuvant chemotherapy and radiotherapy.
All patients received adjuvant antiestrogen. Patients were followed for a
median duration of 33 months. Disease-free survival (DFS) and overall survival
(OAS) were studied for all patients, compared between both groups and related
to the extent of surgery and menopausal status. Results: median age was
46.5 years for all patients; 48 years, and 46 years for
NCT and primary surgery groups respectively. Median DFS was 15 months for all
patients, 16 & 15 months for NCT and primary surgery groups. Median OAS was
24 months for all patients, 22 & 24 months for NCT and primary surgery
groups. Difference in DFS & OAS were highly significant in favour of
postmenopausal patients (p = 0.05 for DFS & p = 0.03 for OAS) while in
primary surgery group the differences between pre and postmenopausal patients
in DFS & OAS were statistically insignificant (p = 0.4). NCT followed by
surgery group patients showed significant improvement in DFS & OAS in
patients performed conservative surgery while in primary surgery group the
difference was insignificant. Freedom of disease was seen in 28.6% in the NCT
group and 37.1% for the primary surgery group. Conclusion: Surgery
post-neoadjuvant chemotherapy neither prolongs DFS nor OAS in comparison with
primary surgery followed by adjuvant chemotherapy. Postmenopausal patients felt much better than premenopausal patients regarding
DFS & OAS.