BACKGROUND AND OBJECTIVESThe attainment of pathological complete response (pCR) after neoadjuvant chemotherapy has been taken as a surrogate marker for disease-free survival and overall survival. This is however dependent on various other parameters such as stage, grade, and biologic markers.DESIGN AND SETTINGSThis is a retrospective study of 365 patients with histologically confirmed non-metastatic breast cancer patients treated with neoadjuvant chemotherapy at the Kuwait Cancer Control Centre between 1998 and 2009.PATIENTS AND METHODSA total of 365 breast cancer patients who had received neoadjuvant chemotherapy from 1998–2009 were analyzed for the relationship of pCR with hormone status, Her2 status, histopathological subtype. Survival analysis was also conducted.RESULTSHormone receptor (HR) negative tumors had a higher pCR as against HR positive tumors, and the highest pCR in our analysis of pathological subtypes were seen in the HR+, Her2neu + and HR−, Her2neu + group. In our study, we could make out the paradoxes that well differentiated, and HR positive tumors had a better survival in spite of having lower pCR. The luminal A subtype also had a better overall survival than the triple negative subtype in spite of having lower pCR with neoadjuvant chemotherapy.CONCLUSIONThough the achievement of pCR retains its significance, it is more prognostic in HR negative tumors. The importance of HR receptor status, grade, and histopathological subtype in the long-term survival has been emphasized.
pCR is associated with better survival in breast cancer patients receiving neoadjuvant chemotherapy. Initial anthracycline-based chemotherapy followed by non-cross-resistant taxane-based chemotherapy along with the addition of trastuzumab in Her2 positive patients might be the optimal neoadjuvant regimen in breast cancer patients.
e18619 Background: The COVID era has shown a rise in Intensive Care Unit (ICU) admissions. This is mainly due to COVID related complications. On the contrary, the public around the world have become more aware about maintaining proper hygiene by wearing masks , using hand wash and keeping themselves clean. As an audit, we conducted a retrospective analysis comparing neutropenic complications during the pre COVID and COVID times at our tertiary care cancer hospital. Methods: We collected data of febrile neutropenia admissions in ICU from March to July 2019-Non Covid (NC) and March to July 2020-Covid (C). The data collection was done including data on nadir total WBC count, use of GCSF, positive cultures, type of malignancy and deaths. The statistical analysis was done using SPSS software version 22. Results: There were 15 patients in the NC dataset and 18 patients in the C dataset. The mean age of NC was 59 (SD-9.2) and that of C was 57. 3 (SD-14). The age and sex were comparable in both the groups. The number of solid organ malignancies constituted 5 (33.33%) in NC set and 8 (44.44%) in C set. The hematological malignancies constituted 10 in each of C and NC sets. Gram negative sepsis was seen in 26.67% and 22.22% in NC and C dataset respectively. There were 4 (26.67%) deaths in NC group and 5 (27.28%) C group. Growth factors were received by 9 (60%) patients in NC group and 15 (83.3%) patients in the C group (p=0.0005). There was no significant difference in the admission, complication and death rates in ICU when comparing the two groups. These results have been depicted in Table. Conclusions: Despite the precautions taken by community during the COVID times, we conclude that there was no significant difference in the neutropenic complications. It also suggests that most of the neutropenic infections are related to the person’s immunity rather than community transmission. The study limitation is that this is a single center study but further audits and prospective studies are warranted in this regard. Keywords - COVID, Non COVID, Neutropenia, Intensive Care Unit. [Table: see text]
e13570 Background: The prognosis rate among the breast cancer patients was less than 50% in India when compared to European countries due to the late diagnosis and most of them diagnosed at an advanced stage of disease. Early detection can reduce the risk of advancement of disease by 30%. There is an immediate need to target both younger population to empower the women with the knowledge on their breast cancer risk and self-breast examination (SBE). So the project aimed to examine the efficacy of a Brief Motivational Intervention (BMI) and Student based Parental intervention (SBPI) based on motivational interviewing as a universal preventive and early diagnosis interventions to fight against breast cancer among the school students using a randomized factorial design. Methods: Daughters and Mothers are always a good dyads for doing an personal health intervention. Since it is a ‘matter of closeness’, a mother and a daughter can easily communicate, intervene and ensure the act of doing in self breast examination.We identified 85 schools (including the Junior high and senior high schools in the northern region of Kerala. The female resource person from the MVR Cancer Centre & Research Institute delivered the awareness session on risk factors of breast cancer breast and SBE. So the attendees demonstrated the SBEs to their mothers and ensure the act of doing monthly. The study utilized a 2 × 2 × 3 factorial design, crossing a BMI; (yes, no) and SBPI (yes, no), with one within-subjects factor (Time; baseline and 10 months). Over 10 months, we recruited cohorts of parent-student dyads and randomize by dyad to one of four experimental conditions: BMI only and BMI and SBPI only. We did the randomization by computer algorithm to ensure that the experimental conditions will balance on prognostic indicators of students and their mother’s on breast cancer risk and including waist to hip ratio, frequency of SBE, healthy dietary intake and physically active. Results: Baseline data collected from students and parents during the summer prior to college matriculation. Follow-ups occurred at 10 months post-baseline for parents in the face to face interview with students at their schools. We found 17% of mothers detected any kind of breast abnormalities and among that, 68% of mothers went for further detailed diagnostic tests. Conclusions: It is an innovative approach incorporating the principles of primary prevention and early detection for the breast cancer among the young mothers of Kerala.
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