Abstract
e11510 Background: Breast cancer is the most common cancer amongst the females of Pakistan. Median age at diagnosis is 47 years. Most patients present in stage III. Majority are treated without neo adjuvant chemotherapy. These patients undergo modified radical mastectomy in surgical institutes where they mostly present and are subsequently treated with PMRT and adjuvant chemo-hormone therapies at cancer treatment facilities. Very few receive therapy direct against Her 2 neu over expression. Here, we report survival of stage III patients treated with surgery followed by adjuvant therapies but without neo adjuvant chemotherapy. Methods: Medical records of patients treated during 2004-2006 were obtained from the department Clinical Oncology Mayo Hospital Lahore. Date of diagnosis and stage was confirmed. Treatment sequence was verified and date of last visit was noted. Patients were contacted on telephone and their follow up was completed up to the end of 2008. The total of 480 patients was studied. Kaplan Meier product limit method was applied for survival analysis. SPSS version 11.5 was used for statistical analysis. Results: A total of 1250 patients of breast cancer were treated during this period. 471 patients were stage IIIA and IIIB and 60 patients were stage IIIC. Most common presentation was stage IIIA with T2N2, T3N1 disease followed by T4b N1 and T4b N2 disease. Majority of the patients were below 50 years of age. FAC, AC or TAC were the commonly used chemotherapies. PMRT was delivered to chest wall and supra-clavicular region. Tamoxifen was prescribed to pre-menopausal and letrazole to post menopausal hormone receptor positive patients.197 deaths were recorded and 274 patients were censored. At a follow up of 5 years median survival was 42 months. Conclusions: Survival of locally advance breast cancer patients treated with primary surgery followed by adjuvant therapies is not very encouraging.
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