Characterization of neoadjuvant and surgical treatment of locally advanced breast cancer

Abstract

A descriptive, longitudinal and prospective study was conducted in order to evaluate the behavior of locally advanced breast cancer –according to its clinical, surgical and anatomopathologic features– in patients diagnosed with stage III and with indication of neoadjuvant chemotherapy at the Arnaldo Milian Castro and the Celestino Hernández Robau University Hospitals in Villa Clara during the period from January 2007 to December 2010. A sample of 52 patients was taken out of the total of cases with histological diagnosis. The data were obtained from the charge sheets of the statistics department, medical records and biopsy ballots, which were recorded in a form. It was found that locally advanced breast cancer predominated in ages from 40 to 59, located in the left breast and the upper outer quadrant, according to the histology of infiltrating ductal carcinoma. The neoadjuvant and anatomo-pathologic scheme most commonly used was adriamycin plus cyclophosphamide, with partial clinical and anatomo- pathologic response, although when adding Doxatacel the clinical response was better, resulting in a significant decrease in the post-neoadjuvant therapy and final anatomo-pathologic stages. The most common surgery performed was the modified radical mastectomy and axillary lymph node dissection. The breast-conserving surgery was conducted in a significant number of patients, where the most common contraindication was the presence of multicentric disease. It is recommended that new randomized trials are conducted in order to assess the neoadjuvant therapy and establish monitoring protocols to increase the candidates for breast-conserving surgery.