Doxorubicin-based neoadjuvant chemotherapy is associated with Poorer Five-Year Survival in patients with locally advanced breast cancer: A retrospective single-center study in Indonesia

One of the therapeutic modalities used to improve survival rate in breast cancer is neoadjuvant chemotherapy, which generally follows a doxorubicin-based regimen for patients with locally advanced breast cancer treated at Cipto Mangunkusumo General Hospital (CMGR). Five-year survival rates with doxorubicin-based versus non-doxorubicin-based neoadjuvant chemotherapy in locally advanced breast cancer are not known. To determine five-year overall survival (OS) in patients with locally advanced breast cancer who underwent doxorubicin or non-doxorubicin-based neoadjuvant chemotherapy at CMGR between 2011 and 2016. Clinical data of a total of 236 patients with locally advanced breast cancer who received neoadjuvant chemotherapy at CMGR during the study period were analyzed using the Kaplan-Meier method, log-rank test, and Cox proportional hazards regression analysis. Five-year OS rates were 37% and 48.9% in locally advanced breast cancer patients administered doxorubicin- and non-doxorubicin-based neoadjuvant chemotherapy, respectively. The probability of death was 1.38 times greater in locally advanced breast cancer patients receiving doxorubicin-based neoadjuvant chemotherapy [95% confidence interval (CI): 0.946-2.026] after controlling for lymphatic vascular invasion, clinical response, clinical stage, radiotherapy, histopathology, grade, and menopause status. Lymphatic vascular invasion had the greatest hazard ratio, at 4.74 (95% CI: 3.046-7.361). Five-year OS was higher in patients treated with non-doxorubicin-based neoadjuvant chemotherapy for locally advanced breast cancer.