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

Sanhita Mukherjee, Bishan Basu, Nilay Mandal, Diptakanti Mukhopadhyay, Biplab Kumar Biswas, Bidyut Mandal.

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.

Key words: ACT, Breast cancer, NACT, Recurrence


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