Manmohan Agrawal

Abstract

Triple negative breast cancer (TNBC) is considered as an aggressive sub group of breast cancer and the incidence are increasing. Neo adjuvant chemotherapy is recommended in TNBC, if ≥cT2 or ≥cN1. Clinical prognostication and postoperative decision-making rely exclusively on whether a pathologic complete response (pCR) is achieved or not. Recent studies confirm the addition of immunotherapy in neo adjuvant protocol achieve a better rate of complete pathological response. The protocol of pretreatment evaluation (mapping, marking of tumour and axilla) requires not only expertise but advanced equipment. Moreover, neo adjuvant therapy and frequent response evaluation of disease adds extra financial and psychological pressure on the patients.

Treating patients in tier three city with limited resources and financial constraint is a challenging task. 50 TNBC patients with follow up of more than 4years were analysed retrospectively. All these patients were treated with upfront surgery and adjuvant therapy. The results were evaluated on the basis of disease free survival and recurrence. The results were found to be comparable.