INFLUENCE OF NEOADJUVANT CHEMOTHERAPY ON THE SIZE AND SPREAD OF THE TUMORAL PROCESS AND INDICATORS OF PROLIFERATIVE ACTIVITY IN BREAST CANCER PATIENTS WHO SUFFERED FROM THE CHRONICLE NUCLEAR POWER PLANT ACCIDENT
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O O Lytvynenko1, O O Lytvynenko2, V O Demianov1
1State Institution «National Research Center for Radiation Medicine, Hematology and Oncology of the National Academy of Medical Sciences of Ukraine», 53 Yuriia Illienka St., Kyiv, 04050, Ukraine.
Objective:
To assess the impact of neoadjuvant chemotherapy on the size and spread of the tumor process and indicators of proliferative activity in breast cancer patients who suffered from the Chornobyl accident.
Materials And Methods:
The 96 patients with breast cancer (BC) who were exposed to ionizing radiation as a resultof the Chernobyl accident were examined. Clinical, radiological, instrumental, morphological, and immunohistochemical research methods were used.
Results And Conclusions:
Before neoadjuvant cytostatic therapy, criteria T0, Tis, T1 was not diagnosed in anypatient. As a result of treatment, complete clinical and morphological regression of the tumor was established in16.7 % of patients. A decrease in staging criteria after neoadjuvant chemotherapy (NCT) was diagnosed in 60.4 %of patients. Analysis of patients with breast cancer by stage grouping before and after NCT showed that there wereno patients at all in the study before the start of treatment. After neoadjuvant therapy, in 29.2 % of women, tumorsin the breast gland were classified as stage I by their criteria. Only 2.1 % of women started treatment with stage IIA. After NCT, the prevalence of the primary tumor met the criteria for stage II A in 20.8 % of patients. 53.1 % ofpatients started treatment with stage II B, and after neoadjuvant therapy, this stage was in 14.6 % of patients. StageIII A was detected in 22.9 % of patients before treatment, after therapy the number of patients with this stagedecreased to 14.6 % of patients. 14.6 % of women started treatment with stage III B, after treatment only 3.1 % ofpatients were classified as this stage. Stage III C was detected in 6.2 % of patients at the beginning of treatment,after NCT, no patients with criteria related to this stage were identified. Stage IV was detected in 1.04 % of patients,both before and after NCT. A decrease in Ki67 values under the influence of NCT was observed in 76 % of patients,and in another 16.7 % of patients complete clinical and pathomorphological regression of the tumor was observed.Thus, according to the values of proliferative activity, positive dynamics for neoadjuvant cytostatic chemotherapywas recorded in 92.7 % of patients.
