Prognostic Factors of Locally Advanced Breast Cancer PatientsReceiving Neoadjuvant and Adjuvant Chemotherapy


Background: Neoadjuvant chemotherapy is known to be beneficial for down-staging patients with locallyadvanced breast cancer. Clinical stage, degree of cell differentiation and expression of estrogen/progesteronereceptors and HER2/neu are all prognostic factors that may effect survival of patients with locally advancedbreast cancer. The present study was conducted to determine their influence in a series of Indonesian patientsMaterials and
Methods: The subjects were a total of 52 patients with locally advanced breast cancer in SardjitoGeneral Hospital Yogyakarta, from January 2003 to June 2006. Survival analysis with Kaplan Meier was testedfor age, clinical stage, degree of histological differentiation, estrogen-progesterone receptor (ER/PR), HER-2expression and neoadjuvant as well as adjuvant chemotherapy. To find the most important influencing factors,significant variables were tested with multivariate Cox regression.
Result: Of the 52 patients with locallyadvanced breast cancer, most were between 40-60 years old (41, 78%), almost half were stage IIIA (23 ,44%),and the majority were negative for ER and PR (32, 61%). Her2 positivity was found in 29 patients (55%) and amoderate histological grade in 26 (50%). Thirty-nine patients were alive at the end of the study period (75%).There were no significant differences in survival between patients with and without adjuvant and neoadjuvantchemotherapy. Tumor characteristics that did influence survival were advanced stage (p<0.001) and histologicalgrade (p<0.001), while HER-2 and ER/PR hormonal status had no effect.
Conclusion: Clinical stage and degreeof histological grade are the most significant prognostic factors for Indonesian locally advanced breast cancercases, while hormonal status and HER-2 did not appear impact on our patient’s survival.