Abstract
809 Background: A low pre-treatment haemoglobin (Hb) level has been shown to negatively influence outcome in the management of tumours of the cervix, bladder and head and neck. In a previous study in breast cancer, low Hb levels prior to neoadjuvant chemotherapy (NAC) were associated with a poor response. The purpose of this study is to further assess the influence of Hb levels on NAC for breast cancer. Methods: 139 patients receiving NAC for operable breast tumours (T2–4, N0–1, M0) were accessed from our prospective database. Patients were treated between March 1999 and June 2004. Median age was 47 (range 25–70). 90 patients (64.7%) were oestrogen receptor (ER) positive, 40 (28.8%) were ER negative and 9 (6.5%) of unknown ER status. Chemotherapy regimens included FEC (5-fluorouracil, epirubicin, cyclophosphamide - 122 patients), AC (doxorubicin, cyclophosphamide - 9 patients), MMM (methotrexate, mitomycin and mitoxantrone - 5 patients) and docetaxel (3 patients). Patients received 4–6 cycles of chemotherapy prior to surgery. The clinical measurement of response was defined according to UICC criteria. Baseline Hb levels were compared for responders (partial or complete) and non-responders (stable or progressive disease) using the Mann-Whitney U test. Results: Overall response rate was 84.9% (118/139) with a clinical complete response rate of 15.8% (22/139). Median Hb levels were 13.4 in responders and 13.5 in non-responders (range 7.9 to 15.8). The distributions of the Hb levels were not significantly different when comparing either responders with non-responders or complete responders with those that did not achieve complete response (p=0.79 and p=0.51 respectively). Conclusions: Pre-treatment Hb levels appear to have no influence on response to neoadjuvant chemotherapy in breast cancer. It is unlikely that correction of anaemia above that which is warranted clinically will improve response rates. No significant financial relationships to disclose.
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