J Korean Soc Ther Radiol Oncol.  2010 Jun;28(2):71-78. 10.3857/jkstro.2010.28.2.71.

Result of Neoadjuvant Chemotherapy, Surgery and Radiation Therapy in Locally Advanced Breast Cancer

• Bae SH
• Park W
• Huh SJ
• Choi DH
• Nam H
• Yang JH
• Nam SJ
• Lee JE
• Im YH
• Ahn JS
• Park YH

• KMID: 1460154
• DOI: http://doi.org/10.3857/jkstro.2010.28.2.71

Abstract

PURPOSE
To evaluate the result of neoadjuvant chemotherapy, surgery, and radiation therapy in locally advanced breast cancer as well as analyze the prognostic factors affecting survival.
MATERIALS AND METHODS
One hundred fifty-nine patients with breast cancer were treated by neoadjuvant chemotherapy between April 1995 and November 2006 at the Samsung Medical Center. Among these patients, we retrospectively reviewed 105 patients treated with neoadjuvant chemotherapy followed by surgery and radiation therapy for a cure with an initial tumor size >5 cm or clinically positive lymph nodes. All patients received anthracycline based chemotherapy except for 2 patients. According to clinical tumor stage, 3 patients (3%) were cT1, 26 (25%) were cT2, 39 (37%) were T3 and 37 (35%) were T4. Initially, 98 patients (93%) showed axillary lymph node metastasis. The follow-up periods ranged from 7~142 months (median, 41 months) after the beginning of neoadjuvant chemotherapy.
RESULTS
Locoregional failure free survival rate and distant metastasis free survival rate at 5 years were 82.1% and 69.9%, respectively. Disease free survival rate and overall survival rate at 5 years were 66.1% and 77.1%, respectively. The results of a univariate analysis indicate that clinical tumor stage, pathologic tumor stage, pathologic nodal stage and pathologic TNM stage were statistically significant factors for disease free survival rate and overall survival rate. Whereas, a multivariate analysis indicated that only hormone therapy was a statistically significant factor for survival.
CONCLUSION
The current study results were comparable to other published studies for neoadjuvant chemotherapy for breast cancer. Hormone therapy was a statistically significant prognostic factor. The patients with early clinical or pathologic stage had a tendency to improve their survival rate.

Keyword

Locally advanced breast cancer; Neoadjuvant chemotherapy; Radiation therapy

MeSH Terms

Breast
Breast Neoplasms
Disease-Free Survival
Follow-Up Studies
Humans
Lymph Nodes
Multivariate Analysis
Neoplasm Metastasis
Retrospective Studies
Survival Rate