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Abstract
?Because of the importance of new methods of treatment of locally advanced breast cancer by preoperative (neoadjuvant) chemotherapy many trials were done to compare the effectiveness of this method over the traditional method of immediate surgical interference and postoperative chemotherapy.
?This study dealt with VEM regimen (Vinorelbine 25mg/m2, epirubicin 35 mg/m2, and methotrexate 20mg/m2 given at day 1 and 8 every 28 days) as a preoperative (neoadjuvant) chemotherapy given to one group of patients suffering from locally advanced breast cancer.
?Another group of patients with locally advanced breast cancer treated by immediate surgical interference and postoperative chemotherapy.
?This study revealed that VEM regimen (as a neoadjuvant chemotherapy in the treatment of locally advanced breast cancer) is effective in downstaging of the disease and well tolerated by the patients.
?Downstaging was obtained in 84% of the patients with a pathological complete response rate of 8%.
?The most common haematologic toxicity was neutropenia occurred in 28% of the patients.
?The most common nonhaematologic toxicity was alopecia in 56% of the patients.
?The surgical interference was less invasive after the use of preoperative (neoadjuvant) chemotherapy due to the obtained downstaging of the disease.
?Operative manoeuvre was easier due to decrease in tumour size and in lymphatic involvement.
?Postoperative wound gaping and flap necrosis decrease after the use of preoperative (neoadjuvant) chemotherapy due to easier dissection of the tumour without extensive undercutting or the need of myocutanious flaps to close the defect.
?Postoperative lymphoedema of the arm decrease after the use of preoperative (neoadjuvant) chemotherapy due to decrease in lymphatic involvement.
?From the previous results and owing to the satisfactorily documented efficacy of neoadjuvant chemotherapy in the treatment of locally advanced breast cancer, we conclude that the use of this method of treatment is very helpful in downstaging of the disease. It makes surgical interference less invasive with easier operative technique and less postoperative complications.