Locally Advanced Breast Cancer (LABC): Real-World Outcome of Patients From Cancer Institute, Chennai

Abstract

PURPOSE There are sparse data on the outcome of patients with locally advanced breast cancer (LABC). This report is on the prognostic factors and long-term outcome from Cancer Institute, Chennai. METHODS This is an analysis of untreated patients with LABC (stages IIIA-C) who were treated from January 2006 to December 2013. RESULTS Of the 4,577 patients with breast cancer who were treated, 2,137 patients (47%) with LABC were included for analysis. The median follow-up was 75 months (range, 1-170 months), and 2.3% (n = 49) were lost to follow-up at 5 years. The initial treatment was neoadjuvant concurrent chemoradiation (NACR) (77%), neoadjuvant chemotherapy (15%), or others (8%). Patients with triple-negative breast cancer had a pathologic complete response (PCR) of 41%. The 10-year overall survival was for stage IIIA (65.1%), stage IIIB (41.2%), and stage IIIC (26.7%). Recurrence of cancer was observed in 27% of patients (local 13% and distant 87%). Multivariate analysis showed that patients with a tumor size > 10 cm (hazard ratio [HR], 2.19; 95% CI, 1.62 to 2.98; P = .001), hormone receptor negativity (HR, 1.45; 95% CI, 1.22 to 1.72; P = .001), treatment modality (neoadjuvant chemotherapy, HR, 0.56; 95% CI, 0.43 to 0.73; P = .001), lack of PCR (HR, 2.36; 95% CI, 1.85 to 3.02; P = .001), and the presence of lymphovascular invasion (HR, 1.97; 95% CI, 1.60 to 2.44; P = .001) had decreased overall survival. CONCLUSION NACR was feasible in inoperable LABC and gave satisfactory long-term survival. PCR was significantly higher in patients with triple-negative breast cancer. The tumor size > 10 cm was significantly associated with inferior survival. However, this report acknowledges the limitations inherent in experience of management of LABC from a single center.

Conditional survival nomogram predicting real-time prognosis of locally advanced breast cancer: Analysis of population-based cohort with external validation

“…Our study suggested that the survival in LABC patients was not consistently unsatisfactory, with a 5 year OS of ~40–75% as described in previous studies ( 2 , 3 ). CS was a novel survival assessment method that allowed real-time estimation of changes in survival based on survived time ( 9 ).…”

“…Locally advanced breast cancer (LABC) is a relatively advanced stage of breast cancer, but benefitting from advances in diagnosis and treatment strategies, the overall survival (OS) has improved in recent years (1)(2)(3). Therefore, more and more long-term survivors hoped to know more accurate prognostic information during follow-up, but LABC still lacked effective prognostic assessment tools.…”

Locally advanced breast cancer

“…Locally advanced breast cancer (LABC) is rare and represents about 5% of newly diagnosed breast cancers; in some less affluent countries however, LABC is present in a higher proportion of patients [ 37 ]. There is no universally agreed on definition of LABC.…”

Analysis of the Predictors of Breast Cancer Patients with Skin Edema and Incomplete Response to Neoadjuvant Treatment

“…Проведенный в ходе нашего исследования факторный анализ показал, что предикторы, оказывающие существенное влияние на разные типы выживаемости, отличаются. В мировой литературе нам не удалось найти масштабных исследований, посвященных данному вопросу, однако есть ряд работ, описывающих значение лишь отдельных факторов [10][11][12][13][14][15][16][17][18].…”

“…В мировой литературе указан ряд и других факторов, влияющих на ОВ. Так, в исследовании Dhanushkodi M et al многофакторный анализ показал, что пациенты с размером опухоли более 10 см, тройным негативным подтипом, отсутствием полного патоморфологического ответа и наличием лимфоваскулярной инвазии (р = 0,001) имели достоверно худшую общую выживаемость [10].…”