Abstract: Introduction: Historically, the standard approach to clinically node-positive breast cancer is with axillary lymph node dissection. However, this has been associated with higher surgical complications and long-term symptomatic risks of lymphedema, seroma, limited mobility in that extremity, and neuropathy which can greatly lessen quality of life. Currently, randomized controlled trials examining the question of whether neoadjuvant therapy can decrease the need for axillary lymph node dissection are ongoing. However, guidelines still recommend upfront systemic therapy for clinically node-positive disease to permit for less extensive surgery on the axilla based on data from other trials.
Objective: This study was aimed at assessing the nodal response to anthracycline based neoadjuvant chemotherapy (cyclophosphamide, doxorubicin/adriamycin and 5-flourouracil (CAF) regimen).
Methodology: This is a 3 year prospective study carried out at the Chukwuemeka Odumegwu Ojukwu University Teaching Hospital (COOUTH), Amaku-Awka. The study span from January, 2021 to December, 2023. All the premenopausal patients with confirmed node positive breast carcinoma who gave their consent were recruited for the study. They were given 4 courses of CAF at 3 weekly interval. The regimen consisted of: cyclophosphamide 500 mg/m2, Doxorubucin 50 mg/m2, and 5-Fluorouracil 500 mg/m2 all were given on day one. The axillary nodes were assessed before and after the 4th course of chemotherapy.
Results: A total of 147 female patients were recruited. The age of the study population ranged from 24 to 54 years with a mean of 40.92±7.98 years. The pre-chemotherapy nodal stages were: 60(40.8%) of the patients, N1 according to AJCC (TNM) staging, 78(53.1%) were classified as N2 and 9(6.1%) were N3. After 4th course of neoadjuvant chemotherapy, the nodal status of majority of the patients was down staged to N0 51(34.7%), N1 66(44.9%), N2 27(18.4%) and 3(2.0%) was N3. The clinical complete response rate cCR in this study in relation to nodal status was 34.7%.
Conclusion: The above findings demonstrated the ability of neoadjuvant chemotherapy to transform clinically node-positive breast cancers to node-negative stage.
Keywords: Breast cancer, Response, Axillary node, Chemotherapy, Neoadjuvant.
Title: AXILLARY NODAL RESPONSE TO NEOADJUVANT ANTHRACYCLINE BASED CHEMOTHERAPY IN BREAST CANCER PATIENTS
Author: Madubogwu, Chimezie Innocent.
International Journal of Healthcare Sciences
ISSN 2348-5728 (Online)
Vol. 13, Issue 1, April 2025 - September 2025
Page No: 345-348
Research Publish Journals
Website: www.researchpublish.com
Published Date: 01-July-2025
