Three Cycles versus Six Cycles of Neoajuvant Chemotherapy in Stage II and III Breast Cancer: 3 Years Overview

Abstract

Background: The majority of breast cancer patients is diagnosed at a young age and present with locally advanced stage which limit the response to treatment and the frequency of conservative surgery. Neoadjuvant chemotherapy increasingly used to achieve better results. The number of cycles which should be given is addressed in this study. Aim: To study the efficacy of increasing number of cycles of neoadjuvant chemotherapy (three versus six cycles of (FAC) protocol) as regards pathological complete response {p(CR)} and frequency of conservative breast surgery. Methods: 260 breast cancer patients were included into 2 groups and treated with neoadjuvant chemotherapy, group A (132 cases) received 3 cycles, and group B (128 cases) received 6 cycles. Results: At the end of neoadjuvant chemotherapy protocol, all cases were underwent surgery either modified radical mastectomy (MRM) or conservative breast surgery (CBS) and were pathologically assessed. The p(CR) was statistically different between the 2 groups. In group B 39 patients (30.5%) achieved p(CR) compared to 12 patients (9.1%) in group A (P value<0.05). Also conservative surgery was more frequent in group B (89 patients) (69.5%) compared to group A (52 patients) (39.4%) which is also statistically significant. The protocol was generally well tolerated, febrile neutropenia was noticed in only 7% of cases in group A and 9% in group B. Conclusion: 6 cycles of FAC protocol of neoadjuvant chemotherapy are better than 3 cycles when used in advanced breast cancer patients as regards p(CR) and frequency of conservative surgery.