Short-term Curative Effect Of TAC Scheme Neoadjuvant Chemotherapy In Breast Cancer

Female breast cancer is one of the most common malignant tumor, a serious threat to women's health and life. Early screening is an effective mean to reduce breast cancer incidence and mortality. To take reasonable and effective treatment methods are our recent focus on diagnosis of breast cancer patients. In the past decades, breast cancer treatment patterns changed greatly in the worldwide. Experienced from lack of scientific guidance, the breast cancer as a local disease, only need local expand treatment to be thought breast cancer is a systemic disease, through evidence-based medicine guiding breast cancer of surgery, radiation therapy, chemotherapy, endocrine therapy, molecular target therapy and cell biological treatment process, so the prognosis of breast cancer has improved steadily. The traditional breast cancer treatment mode mainly used chemotherapy , radiation therapy after radical surgery ,which postponed chemotherapy and multiplied rapid tumor cells, increasing the risk of drug resistance cells and early distant metastasis. However,recently the neoadjuvant chemotherapy, named the preoperative chemotherapy has a lot of advantages which can narrow the primary lesion and the regional lymph nodes, decrease the tumour stage, and improve the operation resection, these advantages can also be a part of the locally advanced breast cancer from"cannot surgery"to"can be surgery", increase opportunities of receiving the breast-conserving surgery in the patients who couldn`t accept this operation at first , kill the micrometastases early,guide the adjuvant chemotherapy. So the neoadjuvant chemotherapy takes more and more attention .Neoadjuvant chemotherapy refers to 2～4 cycles of systemic chemical medication before surgical treatment or radiation therapy in the non-metastatic tumor, so it has been called the preoperative chemotherapy and the primary chemotherapy, which help distinguish the postoperative adjuvant chemotherapy. Currently the neoadjuvant chemotherapy is widely used in breast cancer, laryngeal cancer,and non-small cell lung cancer, cervical cancer,esophageal cancer, colorectal cancer and prostate cancer treatment, improving operation resection,survival rate, and raising the possibility of reserved organs. The earliest neoadjuvant chemotherapy was mainly used to treat locally advanced breast cancer can not surgery . Later, the clinical widespread application and research found that the curative effect of the preoperatie chemotherapy and the postoperative chemotherapy is similar in the therapy of early breast cancer, but the former can improve the breast-conserving surgery , which gradually applied to the therapy of early breast cancer, and become an important component of comprehensive treatment mode of the breast cancer. Neoadjuvant chemotherapy can obviously narrow the primary lesion and regional lymph nodes, reduce the tumor stage, help surgical resection of the local lesion, and early kill subclinical disseminated lesions of the breast cancer. People also adopt the neoadjuvant chemotherapy to further improve the long-term outcome of breast cancer. Studies have shown that the patients who achieved pathological complete remission (pCR) after finished the neoadjuvant chemotherapy , prognosis is better.Fisher also found some growth factors levels of the peripheral blood increased after resecting primary tumor, and promoted the rapid growth of metastasis tumors. But the neoadjuvant chemotherapy can interrupt effectively metastases proliferation, early kill subclinical disseminated lesions of the breast cancer. Thus it can restrain effectively the metastases of the residual lesions . Along with the continuous application of the neoadjuvant chemotherapy, people are more affirmed the value and position of the neoadjuvant chemotherapy for comprehensive treatment of the breast cancer.In order to investigate the short-term curative effect of the neoadjuvant chemotherapy and toxicity reaction in the breast cancer comprehensive treatment ,we choosed 37 cases of II and III stage patients from 2008 to 2010. 37 cases patients were all treated by【TAC】scheme the neoadjuvant chemotherapy, specific drugs for chemotherapy: cyclophosphamide (C) 500mg/m2, d1 intravenous injection , pirarubicin (A) 50mg/m2, d1 intravenous drip , docetaxel (T) 75mg/m2, d2 intravenous drip;21 days for one period of treatment, with 2～6 cycles. 1～2 weeks after the last time the neoadjuvant chemotherapy according to the primary lesion and regional lymph node situation accepted the breast-conserving surgery or the improved radical surgery. Results: cCR 5 cases in 37 cases of breast cancer, accounting for 13.51 %; pCR 3 cases, accounting for 8.11%;PR 18 cases, accounting for 48.65 %;SD 10 cases, accounting for 27.03%;PD 1 case, accounting for 2.70 %. The reaction rate (CR + PR ) was 70.27%, the clinical benefit response was (CR + PR + SD) 97.3%. CR 10 cases in armpits and (or) supraclavicular lymph nodes, accounting for 27.03 % ; pCR 4 cases, accounting for 10.81%;PR 8 cases, accounting for 21.62%;SD 8 cases, accounting for 21.62 %; PD 5 cases, accounting for 13.51 %; 2 cases did not find the lymph node metastasis before and after the treatment. 2 cases accepted the breast-conserving surgery,accounting for 5.41%;35 cases received the improved radical surgery, accounting for 94.59%;of which 9 patients ,who was diagnosed when the tumor stage was late,obtained surgery opportunity after therapy. 22 cases'stage reduced , accounting for 59.46%;9 cases had no changes, accounting for 24.32%; 6 cases'stage rose, accounting for 16.22%.Conclusion: To sum up, the neoadjuvant chemotherapy can narrow the primary lesion and (or)the regional lymph node of breast cancer, reduce the stages, improve the operation resection,early kill the small metastases,make more patients get the opportunities of the receiving breast-conserving surgery,and understand the sensitivity of the tumor to chemotherapy, in order to guide the postoperative adjuvant therapy. Breast cancer as a systemic disease, advocate multidisciplinary integrated treatment , and the neoadjuvant chemotherapy in this treatment mode plays an important role.