Despite an increase in breast cancer awareness in SA and the recent national Breast Cancer Prevention and Control Policy, two-thirds of our patients presented with locally advanced breast cancer. While women with transport problems and work fears were more likely to present with locally advanced disease, there were few socioeconomic characteristics that could identify those at risk of delay to presentation.
In patients with locally advanced breast cancer, decreases in NLR and PLR values parallel to the reduction of tumor load with surgery may cause an increase in immune response and regression of the tumor.
These are promising results and will hopefully translate into improved outcomes with further follow-up and may open the door for incorporating immunotherapies into the standard chemotherapy regimen for locally advanced breast cancers.
The use of neoadjuvant chemotherapy (NAC) has become the standard treatment of locally advanced breast cancer: previous studies have widely demonstrated that a pathological complete response (pCR) after NAC correlates with a higher disease-free survival.
Neoadjuvant chemotherapy with trastuzumab followed by adjuvant trastuzumab versus neoadjuvant chemotherapy alone, in patients with HER2-positive locally advanced breast cancer (the NOAH trial): a randomised controlled superiority trial with a parallel HER2-negative cohort.
Although survival for cases of IBC has improved with multimodal therapy , recent population statistics still demonstrate much lower median survival for IBC cases (2.9 years) than for cases of locally advanced breast cancer (6.4 years) and non-metastatic breast cancer (>10 years).
Eremin et al., "Natural killer (NK) cell profiles in blood and tumour in women with large and locally advanced breast cancer (LLABC) and their contribution to a pathological complete response (PCR) in the tumour following neoadjuvant chemotherapy (NAC): differential restoration of blood profiles by NAC and surgery," Journal of Translational Medicine, vol.
There are two articles that describe practical approaches to patients with locally advanced breast cancer. One is by Dr P Govender, an oncologist from Durban, and the other by Sister K Hill, a nurse from Christiaan Barnard Memorial Hospital, Cape Town.