Multimodal therapy in locally advanced breast carcinoma

Journal Article · Sat Dec 01 04:00:00 EST 1990 · American Journal of Surgery; (USA)

DOI:https://doi.org/10.1016/S0002-9610(05)80772-X· OSTI ID:6228562

Lopez, M J; Andriole, D P; Kraybill, W G; Khojasteh, A ^[1]

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1. Washington Univ. School of Medicine, St. Louis, MO (USA)

Among 879 patients treated for breast cancer between 1975 and 1984, advanced disease was found in 125 (14%). A subgroup of 34 (4%) presented with untreated locally advanced disease without demonstrable distant metastases at the time of diagnosis (stage IIIB = T4abed, NX-2,MO). During the first 5 years (1975 through 1979), 17 patients were treated primarily with sequential radiotherapy and chemotherapy (Group A). From 1980 to 1984 (Group B), the management consisted of four courses of induction multi-drug chemotherapy followed primarily by mastectomy and additional chemotherapy. The mean follow-up for the most recent group (Group B) is 48 months. Follow-up was complete. While the local disease control rate was the same for both groups (76%), the survival was remarkably different. Group A patients experienced a median survival of 15 months, and only one survived 5 years. In Group B, the median survival was 56 months with nine patients (53%) alive between 40 and 76 months, seven (41%) of whom are 5-year survivors. While the overall mortality of patients with inflammatory breast cancer was greater in both groups when compared with the group with noninflammatory disease, the survival of patients in Group B was better than in Group A for both inflammatory and noninflammatory cancers (p less than 0.01). Estrogen receptor, nodal, and menopausal status did not influence survival. These data suggest that neoadjuvant chemotherapy improves survival for patients with stage IIIB breast carcinoma and delays the establishment or progression of distant metastases. Mastectomy is an important component in the treatment of this disease.

• OSTI ID: 6228562
• Journal Information: American Journal of Surgery; (USA), Journal Name: American Journal of Surgery; (USA) Vol. 160:6; ISSN 0002-9610; ISSN AJSUA
• Country of Publication: United States
• Language: English

Related Subjects

550600 -- Medicine
550603* -- Medicine-- External Radiation in Therapy-- (1980-)
62 RADIOLOGY AND NUCLEAR MEDICINE
BODY
COMBINED THERAPY
DISEASES
GLANDS
MAMMARY GLANDS
MEDICINE
METASTASES
NEOPLASMS
ORGANS
PATIENTS
POST-IRRADIATION EXAMINATION
SURGERY
SURVIVAL CURVES
THERAPY