The Response, Operability, and Type of Surgery Following Neoadjuvant Chemotherapy in Sudanese Patients with Locally Advanced Breast Cancer

Dighe

Journal of Family Medicine and Primary Care

et al. 2022

Aim: To assess the response of neoadjuvant chemotherapy in carcinoma breast patients by high-frequency ultrasound. Material and Method: The current single blind, observational study was conducted at rural tertiary healthcare center of Acharya Vinoba Bhave Rural Hospital from October 2018 to Sept 2020. We incorporated breast cancer patients with TNM stages IIIA and IIIB who received neoadjuvant chemotherapy with Cyclophosphamide/Adriamycin/5 FU and Paclitaxel respectively followed by standard surgical procedure modified radical mastectomy. Successive ultrasound examination of the breast malignancy and the axilla was done after 21 days of either of any neoadjuvant chemotherapy for 3 cycles. Assessment of response to neoadjuvant chemotherapy was applied in terms of reduction in the breast tumour volume on ultrasound and percentage of tumour response calculated by Response Evaluation Criteria for Solid Tumours (RECIST). Data were analysed using SPSS version 24.0. Results: Higher frequency of patients was invasive ductal breast cancer. In our study, Paclitaxel group showed better response in terms of CR and PR than CAF group. Our study noticed a consistent decrement in tumour volume after every cycle of either CAF or Paclitaxel NACT. Axillary ultrasound was able to predict the response of axillary lymph nodes in terms of increase or decrease in number and morphological changes after 3 cycles of NACT with similarity on final histopathology. Conclusion: It can be concluded from the results of the present study that high-frequency ultrasound is appropriate tool for assessment of response of primary breast malignancy and lymphnode metastasis in the axilla after neoadjuvant chemotherapy.

Section: Discussionmentioning

confidence: 91%

Assessment of response of neoadjuvant chemotherapy in carcinoma breast patients by high-frequency ultrasound

Dighe

Journal of Family Medicine and Primary Care

et al. 2022

Plastic and Reconstructive Surgery - Global Open

Publications in Plastic Surgery and Reconstruction: A Review from a Developing Country, Sudan

Bakhiet,

Alshareef,

Abuelnour

et al. 2024

Background: Plastic and reconstructive surgery services need to be improved in developing African countries. Research and article publications from those countries are limited. This review was conducted to identify published articles from Sudan in the area of plastic and reconstructive surgery. Methods: This review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines. The Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines were used for the preparation of this systematic review. A comprehensive systematic search was performed using PubMed, ScienceDirect, and Web of Science databases. Articles published in Sudan, specifically in the area of plastic and reconstructive surgery, and written in English were included in this review. Results: The total number of articles that fulfilled the inclusion criteria was 23. The articles were written from 1969 to 2023. Only two articles were published in the 20th century. The most common study type was a retrospective study of eight articles, and the most common study area was Khartoum Teaching Hospital. Regarding the publishing journals, the number of subscription journals was six (30%), whereas open access was 17 (70%). Conclusion: This review demonstrates the lack of articles published on plastic surgery in Sudan. Further investigation is needed to determine the challenges and problems associated with possible clarifications.

Role of Ultrasonography in Response Assessment Following Neoadjuvant Chemotherapy in Locally Advanced Breast Carcinoma: Experience From a Tertiary Care Center

BIDYUT BISWAS,

MD ASIF ALI,

ARABINDA ROY

et al. 2024

Asian J Pharm Clin Res

Objective: Neo-adjuvant chemotherapy (NACT) has a pivotal role in the treatment of locally advanced breast carcinoma (LABC). In this study, we assess the efficiency of ultrasound in the response assessment of NACT in patients with LABC using RECIST criteria and its correlation to the final histopathological report. Methods: 40 patients with LABC underwent clinical examination and ultrasonography (USG) of the bilateral breast and axilla before starting NACT. After receiving three cycles of NACT, a repeat USG and clinical examination were done to assess the response to chemotherapy. Patients with responsive disease underwent radical surgery, and we correlate the findings of histopathological examination (HPE) with those of post-NACT USG findings. Results: After three cycles of NACT, clinical examination showed a complete response in 15 (37.5%) patients and a partial response in 21 (52.5%) patients. While USG detected a complete response in 8 (20%) patients and a partial response in 28 (70%) patients, seven patients, in whom clinical examination did not find any disease, were detected by USG. HPE showed a complete pathological response in 5 specimens, and in the rest of 31 cases, HPE revealed a residual tumor. USG did not miss any of the pCR cases but overestimated CR cases by 9% (3 patients). On the other hand, all partial response diagnoses by USG were acknowledged by HPE. Conclusion: To conclude, it can be said that USG can be used as an effective radiological tool for response assessment and subsequent treatment decisions, especially in places where there is a lack of infrastructure and affordability.