ABSTRACT
In the present study, 20 patients with locally advanced breast cancer were treated with a combined modality strategy from September 1999 to June 2002. Their age ranged from 30-65 years with a mean of 50 years. Thirteen patients were postmenopausal and seven patients were premenopausal. Fourteen cases were in stage IIIb, while six cases were in stage IIIa. A metastatic work up was done and all patients were found to be free from distant metastases before neoadjuvant chemotherapy. The patients received three cycles of different regimens of neoadjuvant chemotherapy. Fourteen patients received 5-flurouracil, adriamycin, cyclophosphamide [FAC], three patients received 5-flurouracil, epirubicin, cyclophosphamide [FEC], two patients received 5-flurouracil, novantrone, cyclophosphamide [FNC]and one patient received cyclophosphamide, methotrexate, 5-flurouacil [CMF]. 90% of the patients had partial responses to the neoadjuvant chemotherapy [the tumor decreased more than 50% of its size]; while only two patients did not respond to treatment. Modified radical mastectomy was done for all patients. Postoperatively, all patients received adjuvant treatment, radiotherapy 5000 cGY, 25 fractions, 3-4 cycles of further adjuvant chemotherapy [FAC, FEC, CMF and FNC] and hormonal treatment, tamoxifen 20 mg/day. The patients were followed up for a variable period of time ranging from 12-24 months. No local recurrence was detected in all patients. Only two patients developed distant metastasis. Disease free survival was 90%. This multimodality approach to locally advanced breast cancer rendered most of the patients disease-free and produced an excellent local control rate