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Comparison between neo-adjuvant chemotherapy and radiotherapy in locally advanced breast cancer Purnagari A, Melvina M. Padjadjaran University Medical Faculty. Bandung, Indonesia Introduction Breast cancer is the second most common cancer in Indonesia. Social, economic, and cultural factors in Indonesia have led patients not to acknowledge the disease and seek treatment in the early stages of breast cancer. Thus, many breast cancer patients in Bandung are diagnosed with Locally Advanced Breast Cancer. Locally Advanced Breast Cancer (LABC), which in general has been defined as stage III in the AJCC system, has a 5-year survival rate of less than 30%-40%. It has the characteristics of both local and advanced cancer. The initial treatments for LABC are neo-adjuvant chemotherapy or radiotherapy. Aim There is still a controversy in choosing the best initial treatment for LABC. The aim of this study is to compare neo-adjuvant chemotherapy and radiotherapy in LABC. Method Randomized clinical trial. Comparing the response, local recurrence, and metastases of 30 LABC patients that have been treated with neo-adjuvant chemotherapy and 30 LABC patients that have been treated with radiation before surgery in dr.Hasan Sadikin Hospital (RSHS), Bandung, Indonesia within the period of 2003-2006. Results In the 30 LABC patients treated with neo-adjuvant chemotherapy, 10% are not responsive, 50% are partially responsive, and 40% are totally responsive. Metastases after three cycles of chemotherapy are not found. In the 30 LABC patients treated with radiation, one third are not responsive, one third are partially responsive, and one third are totally responsive. Metastases were found after 15 radiations to the lung (50%) and liver (10%). Discussion Concluding: neo-adjuvant chemotherapy is the best choice for initial treatment. However, the cost of this treatment is far more expensive than radiotherapy. Therefore in Indonesia, a developing country with a low Gross Domestic Product (GDP), radiotherapy is given more often. Further Reading * Donegan and Spratt: Cancer of The Breast. Fifth edition. Saunders, Missouri. 2002. p579-589, 639-684 * Hortobagyi GN. Treatment of Breast Cancer. In www.nejm.org accessed on April, 14 2006 * Soemitro M. Randomized clinical trial in RSHS within the period of 2003-2006 Summer School Participants Arum Purnagari Bandung. [email protected] & Meta Melvina Bandung [email protected] Acknowledgements We would like to thank: Professor F.F. Wirakusumah, gynecologist and our faculty; Dr. Monty Soemitro, surgical oncologist and his staff; The Dutch Cancer Foundation for financial support; Our families and friends for giving us all their support.