Study of prognostic and predictive factors in locally advanced breast cancer in Egypt

Abstract

Objective We aimed to evaluate the prognosis in locally advanced breast cancer (LABC), and the efficacy of neoadjuvant chemotherapy in inducing pathological response in LABC. Background Despite efforts at early detection, LABC remains a clinical challenge, as distant metastasis develops in most patients, and they will experience disease relapse and eventual death. Patients and methods To study the hematoxylin and eosin-stained slides of pretreatment and post-treatment specimens and correlate them with prognostic and predictive factors. Results LABC in Egypt showed poor prognostic factors such as a high proportion of the cases have a large tumor size (46%) and axillary lymph node (LN) metastasis (87%) and younger age at time of presentation (median = 53 year). These results indicate a more aggressive biology of LABC in Egypt compared with the same group in developed countries. Negative preoperative LN predicts complete response in postoperative LN. Prolonged survival was observed within the triple-negative (P = 0.004) and progesterone receptor negative groups (P = 0.02). The disease-free survival was shortened in positive lymphovascular invasion (P = 0.04) and high histologic grade (0.03). Conclusion LABC in Egypt showed poor prognostic outcome. Triple-negative and progesterone-negative cases that received neoadjuvant therapy showed significant prolonged survival.