الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Breast cancer is considered the most common malignant tumor among females.This study a prospective open label randomized control study conducted in Oncology Center, Mansoura University in a period from January 2020 to May 2023. 152 cases with newly diagnosed stage II and III hormone positive, HER.2 negative premenopausal breast cancer were randomized allocated at a 1:1 ratio into two arms, (experimental arm); patients received neoadjuvant concurrent chemo-hormonal therapy and (active comparator arm); patients received neoadjuvant chemotherapy only. There was no significant difference between the two study arms as regard patient’s baseline characteristics. After neoadjuvant treatment, radiological tumor size, radiological LN, and radiological LN size were significantly decreased in both study groups, with a more significant reduction in radiological LN(s) size in chemo-hormonal group compared to chemotherapy group (P =0.046). As regard type of surgery, fifty six percent of cases underwent modified radicl mastectomy (MRM) with no significant difference between both groups. Ki67 and showed a significant reduction after neoadjuvant treatment in both groups (P <0.001). It is also noted that patients with higher ki67 level responded better to neoadjuvant chemo-endocrine therapy than those with low ki67 (P =0.022). In our study, there was a significant increase in frequency of complete, marked and partial pathological response in chemo-hormonal group (P<0.001). Non-responders were significantly more among chemotherapy group. The analysis of treatment related adverse events revealed that all neoadjuvant treatments were well tolerated. The survival analysis revealed that event free survival (EFS) estimates 94.7% at 20 months interval and 82.7% at 40 months interval in chemotherapy group, also EFS estimates 97.1% at 20 months interval and 92.8 % at 40 months interval in chemo-hormonal group with near significant difference between 2 groups (P =0.074). Finally, we recommend further studies to evaluate efficacy and safety of concurrent neoadjuvant chemo-endocrine therapy vs chemotherapy in hormone-positive, HER.2-negative breast cancer patients with a longer follow up period for better assessment of survival analysis.