الفهرس 
Review of LiteratureOnly 14 pages are availabe for public view
 |  | from | 254 |  |  |
| | | from | 254 | | |
Abstract
B
reast cancer is the most frequent neoplasia in women, with more than 2 million new diagnoses worldwide each year. Population screening based on periodical mammography has led to an increased rate of early diagnosis and a consequent reduction in breast cancer-specific mortality.
For patients with newly diagnosed, operable breast cancer who have an indication for systemic chemotherapy at the time of presentation based on primary tumor factors, chemotherapy is increasingly given before surgery.
The rationale for neoadjuvant chemotherapy is that, in addition to allowing assessment of response to therapy, it can decrease the size or extent of the tumor prior to surgical resection, decreasing the amount of tissue that needs to be resected and potentially allowing breast-conserving surgery in patients who without such chemotherapy would have required mastectomy.
Breast-conserving surgery is considered the preferred approach in early-stage breast cancer, and multiple prospective studies have shown the oncologic safety of breast-conserving surgery followed by adjuvant radiation therapy. Breast-conserving surgery after neoadjuvant chemotherapy has been shown to result in local-regional control rates similar to those in patients undergoing up-front breast surgery.
In addition to reducing the size of primary tumors, neoadjuvant chemotherapy can eradicate disease in the regional lymph nodes and can convert node-positive disease to nodenegative. Recent studies have shown nodal pathologic complete response (pCR) rates of approximately 40% after neoadjuvant chemotherapy, with some variation based on tumor biologic subtype.
The aim of the present study was to compare the clinicopathological features, surgical procedures, and outcome parameters of neoadjuvant chemothearpy and upfront surgery in breast cancer with the aim of comparing the outcome interm of ipsilateral breast tumor recurrence rates and metastasis in two groups.
This was a Comparative study, was conducted in Aswan oncology center on (40) women diagnosed with breast cancer, divided into two groups: (group A): 20 up front surgery patients, (group B): 20 Neo adjuvant chemotherapy patients during 6 months.
The main results of the study revealed that:
There was no statistically significant difference between the two studied groups as regard family history data.
There was no statistically significant difference between the two studied groups as regard staging.
There was no statistically significant difference between the two studied groups as regard biomarkers.
There was statistically significant difference between the two studied groups as regard Metastatic work up.
Based on our results we recommend for further studies on larger patients and longer period of follow up to emphasize our conclusion.
CONCLUSION
T
he neoadjuvant chemotherapy has a nearby significant impact on pathological complete response (PCR) in patients with breast cancer with no significant increased toxicity and has significant higher rates of metastasis compared to upfront surgery. We found in early breast cancer its better to start with upfront surgery and in late breast cancer its is better to start with neoadjuvant chemotherapy.
RECOMMENDATIONS
Further studies on large geographical scale and on larger sample size to emphasize our conclusion.
Understanding the clinical, genetic, and molecular profiles in breast cancer leads to the development of validated predictive and prognostic tools that helps individualize treatment plans for these patients.
Early breast cancer it’s better to start with upfront surgery.
Late breast cancer it’s better to start with neoadjuvant.