RESUMO
Objective: to determine the frequency of pathological complete response [pCR] with neo adjuvant doxorubicin and cyclophosphamide in locally advanced breast cancer [LABC]
Material and Methods: this prospective study was conducted in 92 patients of locally advanced breast cancer. Pathological response was evaluated on modified radical mastectomy [MRM] samples that were performed after 4 cycles of neo adjuvant doxorubicin and cyclophosphamide
Results: the mean age of the study population was 45.63 years. Among these 38 patients [41.3%] had stage T3 lesion, 53 [57.6%] had T4 and only one patient [1.1 %] had T1 at presentation. Ninety patients [97.82%] were with grade 2 and grade 3 tumors. Post anthracycline based NACT 8 [8.7%] patients had pathological complete response, 50 [54.3%] had partial response, 34 [37%] had stable disease. Overall 58 [63%] patients had responded to this treatment
Conclusion: anthracycline based NACT is a good option for patients with locally advanced breast cancer in developing countries. The results are not comparable with developed countries but better results can be achieved if these patients present at an early stage or taxanes based NACT is used to improve the response
RESUMO
Objective: to find out the frequency of germ line BRCA gene mutations among our patients with epithelial ovarian cancer, unselected for age and family history of cancer
Material and Methods: a total of 75 women with histologically proven epithelial ovarian cancer were accrued and 20 cc of peripheral blood sample was collected from each subject and sent to the molecular laboratory of Sunnybrook and Women's College Health Science Centre in Toronto, Canada for detection of BRCA genes
Results: BRCA 1 and 2 genes mutations were found in 9 [12%] patients. BRCA 1 mutation was more common found in eight [88.8%] patients as compared to BRCA2 in 1 [11.2%] patient. Out of 9, six mutations were unique to our subjects and remaining three have also been reported in Dutch and Belgian families. All but one BRCA 1 mutation were found in exon 11. BRCA gene mutation was detected in 35.7% patients of with positive family history of breast and ovarian cancers. All four patients who had ovarian cancer as a second malignancy after breast cancer were positive for BRCA mutation
Conclusion: the frequency of ovarian cancer in our patients is comparable to what has been reported in Western literature. The correlation between family history and probability of finding gene mutation in these patients can be used to identify the families to be tested for the gene mutations. Genetic testing can identify women and their families at increased risk of ovarian cancer