Combination chemotherapy with mastectomy or radiotherapy for stage III breast carcinoma: a Cancer and Leukemia Group B study.

Abstract

One hundred thirteen evaluable patients with previously untreated stage III breast carcinoma were treated with three monthly cycles of cyclophosphamide (CYC), doxorubicin (DOX), 5-fluorouracil (5-FU), vincristine (VCR), and prednisone (PRED) (CAFVP). Subsequently, 91 (81%) were deemed operable. Patients were then randomized to receive surgery or radiotherapy (RT) to determine which of these modalities afforded better local tumor control. All patients also received 2 additional years of CAFVP in a further attempt to eradicate local disease and systemic micrometastases. Forty-one of the randomized patients have relapsed. Approximately half of the initial relapses in each arm were local. The overall duration of disease control was similar following either modality, with a median of 29.2 months for surgery patients and 24.4 months for RT patients. Similarly, there was no major difference in survival related to randomized treatment with an overall median of 39 months (median follow-up 37 months). Pre- or perimenopausal status and inflammatory disease were associated with shorter disease control and survival. Treatment was generally well tolerated and toxicity was acceptable. This study demonstrates that prolonged control of stage III breast carcinoma can be achieved with combined modality therapy in which cytotoxic chemotherapy precedes and follows treatment directly primarily at the breast tumor, using either surgery or RT. Nevertheless, new regimens must be designed if significant advances that may lead to the cure of this disease are to be achieved.

Induction Chemotherapy with Versus Without Hormonal Synchronisation in Locally Advanced Breast Cancer

“…In our series as a whole (n = 69) the ACFuM treatment response rate was 61%, a figure in good accord with those of 65-72% obtained by others using doxorubicin containing chemotherapy regimens in stage 111-IV breast cancer patients (7,8).…”

Application of a rhomboid flap for the coverage of defects after malignant breast tumor resection: A case report

“…Touboul et al (29) reported that BCS is not inferior compared with mastectomy for the treatment of LABC after chemotherapy in regards to overall survival rates if residual tumor sizes were small. However, the optimal local management for patients with LABC remains undefined (14,(29)(30)(31). This warrant further study, particularly following recent advancements in systemic therapy.…”

Study on the role of primary systemic chemotherapy with anthracycline combination schedule in locally advanced breast cancer: long term follow up data

“…But approximately 10-20% of patients get complete clinical response and 50-60% achieves a partial response. [24][25][26][27][28][29][30] Thus it proves beyond doubt the role of Anthracycline combination schedule in Indian women in tumour response.…”