Assessment of prognostic factors for locally advanced breast cancer

In spite of apparent improvement in outcome in locally advanced breast cancer, the prognosis remains dismal in many patients. The aim of this study was to define prognostic subgroups within this heterogeneous entity. The prospective follow-up study was carried out for a period of three and half years involving patients attending the radiotherapy department of Burdwan Medical College and Hospital. Forty-five patients with clinical stages IIIA and IIIB breast cancer were treated with neoadjuvant chemotherapy followed by mastectomy, radiotherapy and completion of chemotherapy with an objective to assess the 2 years disease free and overall survival and to find out the correlates of prognosis. On follow-up disease-free survival and overall survival at 2 years were noted to be 60% and 80% respectively. Patients with age more than 45 years, earlier stage, less than 4 positive axillary nodes, tumour size less than 8 cm, oestrogen receptor positive and Her-2-neu negative status and lesser number of chemotherapy cycles required before surgery had better outcome though not statistically significant. Thus it can be concluded that the above mentioned prognostic variables are strong predictors of treatment outcome in locally advanced breast cancer though further studies with larger sample size are required to establish their statistical significance.