How Effective is the Treatment of Locally Advanced and Metastatic Breast Cancer in Developing Centres? A Retrospective Review

Abstract

BACKGROUND: The use of chemotherapy in advanced metastatic breast cancer remains a subject ofcontroversy. The thought of MicKinnon et al (early 1950s) that the course of breast cancer wasunaffected by chemotherapy has been refuted by results of treatment in the developed countries. Thepoor result of treatment in developing centres still compares with prechemotherapy era. Consequently,The McKinnon’s thought may still lurk. We compared the survival of chemotherapy treated withchemotherapy untreated cancer of breast patients.METHOD: Records of breast cancer patients who presented and died between January 2010 and May2014 were reviewed. The primary outcome was overall survival. Records of patients that receivedchemotherapy with or without other tumor directed specific therapy were compared with records ofpatients who did not receive any tumor directed therapy.RESULT: Thirty-one patients received chemotherapy while 25 patients did not. All were females, morethan 90% were of the patients had advanced or metastatic disease. Treatments were not biologicallydirected and treatment plans were largely compromised and suboptimal. The overall mean survival was19.2 ±9.2 months, and the median duration was 17.5 months(range 6-44months). The overall survivalwas not statistically different between the two groups (p= 0.230, unequal variance assumed). Theobjective of using neoadjuvant chemotherapy for fungating lesions was not achieved.CONCLUSION: In advanced and metastatic breast cancer, outcomes of patients who receive suboptimalregimen of cytotoxic chemotherapy do not differ from chemotherapy untreated patients.