Adjuvant medical therapy

ABSTRACT Background 25% of primitive breast cancers overexpress the HER2 oncoreceptor which is a poor prognostic factor, indicating a rapid tumor growth and causing a higher incidence of recurrence and metastasis with reduced survival. In Algeria, there are about 6000 new cases of breast cancer per year, about 25% overexpress HER2. Methods A retrospective study of 210 patients with breast cancer in the adjuvant setting at the department of medical oncology between 2006 and 2009. Results Median age of patients was 46 years (range 23 to 75) (15% less than 36 years). In more than half of our patients: tumor size was between 2-5cm, Stage IIB-IIIB, SBR grade II-III (88%), with a predominance of infiltrating ductal carcinoma associated with lymph node dissemination and capsular rupture. Almost half of our series has a positive hormonal status. The delay of the treatment with trastuzumab was between 1-18 months post radiotherapy. Cardiac toxicity has occurred in 3 patients (dilated cardiomyopathy and severe mitral insufficiency) requiring to stop the treatment. 10% of patients relapsed (especially liver, bone) after 25-36 months (6 months after completion of trastuzumab for the most part): they are mainly over 35 years (71%), a negative hormonal status, with lymph node dissemination and capsular rupture for almost majority. Patients under 36 years are mainly stage IIB, SBR II-III, with lymph node dissemination and capsular rupture for all, a negative HR status in more than 55%. There were two deaths (beyond 36 months). Conclusion Trastuzumab is a remarkable progress in the treatment of breast cancer. It provides, in combination with chemotherapy, a higher response rate, prolonged remission and a significant advantage for survival, reducing the risk of recurrence in the adjuvant setting. Disclosure All authors have declared no conflicts of interest.