FREQUENCY OF NEUTROPENIA IN ADRIAMYCIN BASED NEO ADJUVANT CHEMOTHERAPY IN LOCALLY ADVANCED BREAST CANCER.

Abstract

Background: Breast cancer is the leading cause of cancer death in women worldwide. Objective: To determine the Adriamycin-based Neoadjuvant Chemotherapy, Neutropenia Incidence in Locally Advanced Breast Cancer. Methods: This descriptive case series research was performed at the Karachi Institute of Radiotherapy & Nuclear Medicine Karachi Department of Clinical Oncology from 16-11-2017 to 16-05-2018. Non probability consecutive sampling was applied. Inclusion criteria were biopsy proven locally advanced breast carcinoma stage II/III, ECOG performance status 0 and 1,no prior specific treatment, age between 20 to 70 years with normal cardiac, renal and liver functions and adequate bone marrow reserves. Exclusion criteria were any treatment chemotherapy, radiotherapy, or surgery prior to presentation,.had neutropenia prior to the start of chemotherapy. Neutropenia grading were performed on basis of common terminology criteria for adverse events.The data were analysedon software SPSS version 21.0. Results: Ninety six patients were enrolled. The mean age of our sample cases was 52.43 ± 10.08 years with a minimum age of 30 years. While maximum age was noted to be 69 years. The mean period of the disease was 10.49 ± 4.98 months and the minimum duration of the disease was 6 months and 24 months was the maximum duration of the disease. Mean neutrophil count was noted to be 1589.58 ± 350.21/mm3with minimum neutrophil counts was 1100 while maximum neutrophil count was 2500/mm3). Neutropenia was noted in 51 (53.1%) of our study cases.Among these 51 who developed neutropenia, 22 (43.13 %) developed after first cycle of chemotherapy, 12 (23.52%) developed after 2nd cycle, 9 (17.64%) after 3rd cycle, 4 (7.84%) after 4th cycle and 4 (7.84%) after 5th cycle of chemotherapy (p=0.000). Conclusion: Neutropenia should be tested at an early stage in patients receiving neoadjuvant therapy with Adriamycin, which plays an important role in the treatment modalities of these patients, thereby enhancing the quality of care of these patients and reducing the frequency of hospitalization due to neutropenia.