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Six‐year results of a multimodality treatment strategy for locally advanced breast cancer
Author(s) -
Piccart Martine J.,
de Valeriola Dominique,
Paridaens Robert,
Balikdjian Daniel,
Mattheiem Wolrad H.,
Loriaux Claude,
Arrigo Célestina,
Cantraine Francis,
Heuson JeanClaude
Publication year - 1988
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19881215)62:12<2501::aid-cncr2820621209>3.0.co;2-5
Subject(s) - medicine , surgery , radiation therapy , breast cancer , vincristine , mastectomy , cyclophosphamide , tamoxifen , population , fluorouracil , chemotherapy , cancer , environmental health
Between 1976 and 1982, 59 patients with locally advanced breast cancer were treated with preoperative supervoltage radiotherapy, adjuvant preoperative and postoperative hormonochemotherapy, and modified radical mastectomy. Systemic treatment, which was started simultaneously with radiotherapy, consisted of a combination of daily oral tamoxifen and a monthly alternation of Doxorubicin + vincristine and cyclophosphamide + methotrexate + 5‐fluorouracil (CMF). One of each cycle was given preoperatively at half dosage and five of each were repeated postoperatively at full dosage. All patients became operable. Results of pathologic examination of the operative specimen, available in 51 patients, showed complete disappearance of tumor tissue in breast areas in eight patients, of which three still had positive axillary nodes. After a median follow‐up time of 6 years locoregional failure was observed in 12 patients (20%) but in only three (5%) did it occur before distant failure. The actuarial median survival of the entire patient population is close to 4 years. Seven patients are alive without recurrence at >9 years. This aggressive multidisciplinary treatment approach is associated with a projected 30% long‐term survival (10 years), excellent local control, but substantial toxicity.