Taxane and Anthracycline Based Neoadjuvant Chemotherapy in Locally Advanced Breast Cancer in India

Breast cancer is the most common cancer among females in India, as per urban cancer registries. The Annual Age Adjusted Rate (AAR) varies from 30 per 100,000 in Mumbai to 33.4 per 100,000 in Delhi (Manoharan et al., 2010). LABC refers to large breast tumors (>5 cm) associated with either skin/ chest wall involvement or with fixed axillary lymph nodes or spread to ipsilateral internal mammary or supraclavicular nodes. It accounts for 10-20% of all breast cancers in the west and the long term outcome is around 60-70% in different series (Giordano, 2003). In India , LABC accounts for 30-35% cases , with a five year survival of not more than 50% (Chopra, 2001). Neoadjuvant chemotherapy (NACT) is now the standard of care for locally advanced and inflammatory breast cancer. The use of NACT has several advantages, like treatment of micro metastasis and downsizing the tumor which also helps in increasing rates of breast conservation surgery (Mathew et al., 2007). Previous