Response to neoadjuvant chemotherapy in breast cancer in a resource limited environment
Objective: Assess the outcome of neoadjuvant chemotherapy using Adriamycin and Cyclophosphamide followed by Paclitaxel (AC-P regime) in breast cancer.
Methods: A prospective observational study of newly diagnosed breast cancer patients with palpable breast lumps on neoadjuvant chemotherapy of AC-P regime. Age of the patients, tumour size, stage, estrogen, progestogen and HER2 receptor status were noted. Tumour size measured at presentation, first, third, fifth, sixth and eighth doses to determine response as defined by the UICC method i.e. complete clinical response, partial clinical response, stable disease and progressive disease.
Results: Complete clinical response was observed in 40% of 35 patients studied. Complete clinical response was found in 81.8% tumours less than 5cm in diameter while 20.8% of tumours greater 5cm.had complete clinical response. (X2 =11.6, p= 0.001) Eighty-eight percent complied with treatment schedule. Mastectomy was done in 34.2%, Breast conservation surgery (BCS) in 14.2%, and 17.1% lost to follow up.
Conclusion: Neoadjuvant chemotherapy using AC-P sequential regime is effective in breast cancer with tolerable side effects and excellent treatment compliance in the study population.
Keywords: Neoadjuvant chemotherapy, breast cancer, clinical response, compliance, limited resource