A Study Protocol for Assessment of Outcomes of Adjuvant versus Neoadjuvant Chemotherapy in Stage-IIIA of Breast Cancer

Background: Locally advanced breast cancer (LABC) includes stage III along with stage IV breast cancer and consists of operable and inoperable advanced breast cancer and metastatic disease. LABC is among the most common breast malignancies with increasing incidence now a days. In India, it accounts for 30-35% of all cases. The use of neo-adjuvant chemotherapy (NACT) for the treatment of LABC offers benefits like initiation of early systemic treatment, the drugs can be delivered via intact vasculature, the tumours can be down staged which helps to convert inoperable tumours into operable tumours and renders tumours suitable for breast conserving surgery (BCS). This study is aimed to compare the outcomes of neoadjuvant and adjuvant chemotherapy using taxane based drugs for locally advanced breast cancers.

Methodology: This was an observational study will be undertaken in AVBRH. Total 40 patients will be enrolled in the study. Confirmed patients of breast malignancy either by FNAC or true cut histopathology with advanced breast malignancy confirmed on FNAC or true cut histopathology and planned for neo-adjuvant chemotherapy will be included in the study. For all the patients HER2, PR and ER status will be checked via immunohistopathology. Data will be analysed with appropriate statistical tests.

Results: We expect neoadjuvant chemotherapy to have better surgical outcomes compared to neoadjuvant chemotherapy.

Conclusion: Neoadjuvant paclitaxel based chemotherapy can be a better option for patients undergoing BCS (breast conserving surgery).