Pathological Response Rate of Paclitaxel Based Dose Dense and Conventional Neoadjuvant Chemotherapy in Locally Advanced Female Breast Cancer Patients

Abstract

BACKGROUND Locally advanced female breast cancer patients have the highest risk of recurrence and distant metastasis. Taxane-based neoadjuvant chemotherapy gives a more pathological response. The purpose of this study was to assess the pathological response rate of paclitaxel-based dose-dense and conventional neoadjuvant chemotherapy in locally advanced female breast cancer patients. METHODS In this observational study, a total of hundred locally advanced female breast cancer patients were randomly selected for neoadjuvant chemotherapy. Fifty patients received three weekly paclitaxel 200 mg/m2 (4 courses) and other fifty patients received weekly paclitaxel 80 mg/m2 (10 courses) along with three weekly doxorubicin 50 mg/m2(4 courses in both arms). Chemotherapy-induced clinical response in both arms was weekly assessed by tumour and lymph node size measurements, change in consistency and fixity. Pathological response of chemotherapy in each arm was assessed by taking the difference of mean tumour volumes and presence of chemotherapy-induced fibrosis and collections of histiocytes in lymph nodes. RESULTS There was statistically significant pathological reduction after neoadjuvant chemotherapy was seen in three weekly arms (68.18 cm3 to 37.22 cm3 P-value 0.000), in the weekly arm (68.42 cm3 to 18.04 cm3 P-value 0.000) and difference in reduction of tumour volume (more in weekly arm -50.38 cm3 versus 30.86 cm3, Pvalue 0.000). CONCLUSIONS Locally advanced female breast cancer patients receiving neoadjuvant chemotherapy with paclitaxel showed a better pathological response rate. It was more in the weekly paclitaxel arm. KEY WORDS Pathological Response Rate, Neoadjuvant Chemotherapy, Locally Advanced.