Pattern of relapse in 412 cases of locally advanced breast cancer (LABC) from a single centre in India

Abstract

12012 Background: Breast cancer is now the commonest cancer in many parts of India and the incidence varies from 12 to 31/100,000 and is rising. Locally advanced breast cancer (LABC) continues to present a challenge due to its poor prognosis. The aim of this study is to study the pattern of relapse and survival of these patients. Methods: This analysis was done of LABC patients who had received combined modality treatment composing of FEC protocol, with MRM and locoregional radiotherapy followed by adjuvant hormonal treatment over a period of 10-years from January 1995 to December 2004. The end points were relapse and overall survival. Follow up was done till June 2007. Results: A total of 609 patients were studied which comprised 26% of our new patients. Four hundred and twelve patients completed standard combined modality treatment. A total of 173 patients (42%) developed relapse. Median age in these patients was 47 years (range 25–83) and premenopausal patients constituted 48%. Local (chest wall) relapse was seen in 7.5%, regional relapse (ipsilateral axilla, supraclavicular fossa) in 3.0%, systemic relapse in 27.4%, locoregional and systemic relapse together in 4.1%. Contralateral (metachronus) breast cancer developed in 1.5%. Lung (10.4%) was the commonest site of systemic metastasis followed by bones (8.0%), liver (7.3%), brain (5.3%) and others (0.5%). Median time to systemic relapse was 20 months. Median overall survival in patients who developed systemic relapse was 36 months and 55 months in those who developed locoregional relapse. However, median survival in all patients (412) has not been reached. Conclusion: Systemic relapse is a major problem and highlights the poor prognosis in these patients with LABC. No significant financial relationships to disclose.