Multimodality treatment of noninflammatory stage IIIb breast cancer.

BACKGROUND AND OBJECTIVES: The 1990s have established the contribution of multimodality therapy in the management of IIIb noninflammatory breast cancer (IIIb NIBC), by reducing the odds of recurrence and death. METHODS: A total of 300 women with IIIb NIBC received a multimodality therapy. The treatment consisted of neoadjuvant chemotherapy [FAC (5-fluorouracil, Adriamycin, cyclophosphamide) regimen], radical (Halsted) mastectomy or modified (Patey mastectomy), postoperative radiotherapy, and adjuvant chemohormone therapy [FAC regimen + cyclophosphamide, 5-fluorouracil and methotrexate (CMF) regimen or Tamoxifen]. RESULTS: Complete or partial clinical response (CR or PR) after neoadjuvant chemotherapy was obtained in 83% patients. Ninety-nine patients (33%) survived 5 years without evidence of disease (NED). The uni- and multivariate analyses factors that had significant influence on the treatment results were: clinical response to neoadjuvant chemotherapy, pathological tumor size, and microscopical status of the axillary lymph nodes. CONCLUSIONS: We conclude that neoadjuvant FAC regimen chemotherapy is very effective in producing objective tumor regression and offers the benefit of radical mastectomy to patients with previously unresectable IIIb NIBC.

[Further studies on the efficacy of inductive chemotherapy in patients with locally advanced stage of mammary cancer]. / Dalsze badania nad skutecznoscia indukcyjnej chemioterapii u chorych na miejscowo zaawansowanego raka sutka.

In a period from 1.01.1979 to 31.12.1984 in the Oncology Centre, Department in Cracow, 202 female patients with locally advanced stage of mammary cancer (T3-4 a-d, N 2-3) were treated with inductive chemotherapy with following local treatment completed with maintenance treatment. The aim of this study is to try to show distant results of the treatment based on current experiences and to analyse failure reasons. Kaplan-Mayer method was used to estimate probability of 3 and 5 year lasting surviving.

Results of combined treatment of patients with locally advanced breast cancer.

Eighty-seven women with previously untreated locally advanced, inoperable breast cancer were treated by induction chemotherapy combined with subsequent local and systemic treatment. Inflammatory breast cancer was diagnosed in 72 (87.7%) of these patients. In the remaining 15 patients, cancer of the breast in stage T3-4 N2b-3 according to the UICC classification was diagnosed. After remission induction, the patients were irradiated or operated upon. Maintenance chemotherapy was given after local treatment. The 3-year survival rate (61.5%) in the group of patients treated by surgery was significantly higher than the patients treated by irradiation (32.4%) or chemotherapy alone (12.5%). On this basis, a new program of treatment of locally advanced, inoperable breast cancer has been proposed.