Ibrahim Em, Al-Gahmi Am, Zekri Jm, Awadalla Ss, Elkhodary Tr, Fawzy Ee, Bahadur Ya, Elsayed Me, Zeeneldin A, Al-Ahmadi Rh, Linjawi Ah
Department of Oncology, King Faisal Specialist Hospital and Research Center, Jeddah 21499, Kingdom of Saudi Arabia.
Ecancermedicalscience. 2009;3:161. doi: 10.3332/ecancer.2009.161. Epub 2009 Oct 12.
Locally advanced breast cancer (LABC) is common in developing countries and it frequently affects younger women. Patients do very poorly when treated by locoregional therapy alone; therefore, pre-operative systemic therapy (PST) is commonly used.
Medical records of 64 Saudi patients with LABC treated with PST in a single institution were retrospectively reviewed.
At diagnosis, most patients were young (median age 41 years), and had poor clinicopathological characteristics. Following surgery, complete pathologic response (pCR) in the breast was achieved in 13 patients (20%). Of 62 patients with known nodal status, 22 (34%) had negative axillary nodes. Presence of oestrogen receptor (ER) negative tumour was the only dependent variable that predicted pCR in the breast (p = 0.03). At a median follow-up of 42 months, the median progression-free survival (PFS) was 48 months (95% CI, 20-76 months) and the projected five-year overall survival (OS) was 68%. The recently published scoring system (Jeruss et al (2008) J Clin Oncol26 2 246-52), was the only variable that independently influenced PFS, while ER negative tumours and presence of lymphovascular space invasion were the only factors that adversely affected OS.
despite the use of standard multi-modality approach in the management of patients with LABC, prognosis remains guarded.
局部晚期乳腺癌（LABC）在发展中国家很常见，且经常影响年轻女性。仅采用局部区域治疗时，患者预后很差；因此，术前全身治疗（PST）被广泛应用。
回顾性分析了一家机构中64例接受PST治疗的沙特LABC患者的病历。
诊断时，大多数患者较年轻（中位年龄41岁），且具有不良的临床病理特征。手术后，13例患者（20%）实现了乳腺完全病理缓解（pCR）。在62例已知淋巴结状态的患者中，22例（34%）腋窝淋巴结阴性。雌激素受体（ER）阴性肿瘤是预测乳腺pCR的唯一相关变量（p = 0.03）。中位随访42个月时，中位无进展生存期（PFS）为48个月（95%CI，20 - 76个月），预计五年总生存期（OS）为68%。最近发表的评分系统（Jeruss等人（2008年）《临床肿瘤学杂志》26卷2期246 - 52页）是唯一独立影响PFS的变量，而ER阴性肿瘤和存在淋巴管侵犯是仅有的对OS产生不利影响的因素。
尽管在LABC患者管理中采用了标准的多模式方法，但预后仍然不容乐观。
