Neoadyuvant Hormonotherpy for Posmenopausics Women with Locallity Advanced Breast Cancer
Authors: Novoa Vargas Arturo  
Published: January 2013

Objective: Present display the objective respond, frequency complete clinical response and pathological complete response with the use of induction hormonotherapy in posmenopausic women with locally advanced breast cancer, (stages III).
Methods: Analysis ina Regional General Hospital of a State of Mexico, Mexico;80 patients with chanalicular infiltrate breast cancer. Positive hormonal receptors: estrogen and progesterone, inmunohistochemical study with Her2 and p53. Eligibles patients were treated in a prospective study, to double blind, using per os: letrozol, 2.5 mg; exemestan, 25 mg and anastrozol, 1 mg with aromatase inhibitors; tamoxifen, 20 mg; during 36 consecutive months. Reports were taken at the beginning, subsequent to 3 months and 6 months ago to evaluate the frequency of objective respond. Patients, whom did not show response to neoadjuvant therapy, became treatment with radiotherapy. Patients, whom showed complete or partial clinical respond, went candidates to radical mastectomy. It was used statistical method Chi 2, with p of Mantel-Haenzel table to evaluate differences.
Results: During a period of 3 years, january of the 2006 to january of the 2009, 4 groups of patients, 80 studied altogether; the age average was 66.5 years old, with a rank of 45 to 75 years with breast cancer, stages IIIA to IIIB, FIGO stages. Objective respond, OR=55%, 44 patients; Clinical respond, 32 patients (40%); ClR plus CPR, complete pathological respond, 12 patients (15%), p=0.05; Complete pathologicalrespond was founded in 12 patients (15%); 40% with aromatase inhibitors and with tamoxifén TMX, 15%, p=0.05. Without Clinical respond (<50% tumoral volume) in eleven patients: 5 patients; 25% in tamoxifen group and 19% in patients with aromatase inhibitors group, p=0.05. These patients over express the proteins HER2/neu and p53 were positive. Collateral effects used NA hormonotherapy with aromatase inhibitors was 23% and with the use of tamoxifen in 32% of the patients, p = 0.05. They didnt respond to neoadyuvant therapy with hormonal receptors <30%, 19% aromatase inhibitors patients; with anastrozol, 10%; with exemastane, 5%; with letrozol, 4% and 25% with tamoxifen; reason why, they received treatment with radiotherapy, because they didnt accept chemotherapy. All patients candidates to surgery were benefitted with the mastectomy surgery.
Conclusions: HTNA is a good therapeutic alternative in posmenopausic women with locally advanced breast cancer, whom didnt accept chemotherapy.
Work shows efficacy of the HTNA for identify patients with breast cancer and hormonal receptors positives, without over express the protein HER2 and p53, they have better survive prognosis and could be rescue with mastectomy.
Its a preliminary study shows there are significance difference in objective respond between aromatase inhibitors and tamoxifen treatments, used in NA form for patients with breast cancer stage III.
In future we will search objective respond between hormonotherapy and chemoterapy used in NA form, in posmenopausic patients.