The choice of neoadjuvant treatment of menopausal patients with locally advanced chemoresistant luminal breast cancer
Smolanka I.I. , Ivankova V.S., Movchan O.V., Ivankova O.M., Lyashenko A.O., Loboda A.D., Dosenko I.V., Lygyrda O.F., Bankovska N.V., Kovalchuk S.I., Lokes I.V.
Summary. Locally advanced breast cancer (LABC) treatment is a complex problem of modern oncology that requires effective solutions. The procedure for treating LABC is usually determined by the following sequence of stages: systemic neoadjuvant chemotherapy, surgical treatment followed by radiation. For breast cancer luminal subtypes, the method of choice is the use of endocrine therapy (ET). Despite, in general, effective hormonal therapy, a significant part of patients with luminal subtypes develop relapse and (or) progress metastatic disease. The aim of the study was to increase the effectiveness of neoadjuvant treatment of patients with locally advanced chemoresistant luminal breast cancer through combined therapy. Materials and methods. 40 patients with locally advanced chemoresistant luminal breast cancer (LACRLBC) in menopause were divided into two groups: the 1st group, which received endocrine therapy (ET); the 2nd group received ET and radiation therapy. Results. In 1st group, tumor response to treatment was observed in 70.0±1.56%, of which 25.0±3.12% had complete regression (CR), and 45.0±2.8% had partial regression (PR). In the 2nd group, the response of the tumor to the treatment was achieved in 55.0±1.91%, while PR was achieved in 40.0±2.18%, while in CR it was 15.0±2.24%. In the 1st group 95.00±1.15% breast conserving operations were performed; in the 2nd group in 74.67±1.32%. 1st group, a decrease in the tumor mass by 51.41±2.24% was determined, in the 2nd group by 64.56±1.72% (t=3.06; p=0.002). Conclusions. Thus, the combined treatment leads to an increase in the cases of partial and complete regression, allows to use breast conserving operations to a greater extent. Preoperative hormone therapy with aromatase inhibitors is a reasonable alternative to preoperative chemotherapy in postmenopausal patients with LACRLBC with a positive status of steroid hormones, especially in the elderly.
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