[Prognostic and predictive factors in breast cancer].

Recent data on prognostic and predictive significance of breast cancer-associated molecular markers are presented and their clinical value in making individual prognosis and choosing adequate therapy is discussed. Markers of tumor proliferation, steroid hormone receptors, factors of epidermal cell growth, plasminogen activators and inhibitors, factors influencing angiogenesis and apoptosis and genome characteristics are considered. It is concluded that only Ki-67, ER, PR and Her-2/neu may be recommended for clinical use.

[Prognostication of hematotoxicity for radio- and chemotherapy in patients with breast cancer]. / Prognozirovanie gematotoksichnosti pri luchevoi i khimioterapii u bol'nykh rakom molochnoi zhelezy.

The effectiveness of radiation and chemotherapy for breast cancer depends on individual response to drug-induced toxicity. The response can be evaluated by means of myelodepression. To this end, changes in leukocyte DNA level after ex vivo gamma radiation test were used as a criterion. Patients, aged 29-78, with tumors stage IIIB-IV received standard radiotherapy (50 Gy) or cyclophosphamide-methotrexate-5-fluorouracil (CMF). Clodronate alone was given to 26 patients and prior to a CMF course. The method proved prognostically effective since it revealed a significant inverse relationship between S-index and leukocyte nadir for both modalities. However, chemotherapy resulted in more pronounced leukopenia. With clodronate administration, the correlation was not significant. When clodronate was supplemented with CMF chemotherapy involved a significant relationship was observed between the two factors.

[Adjuvant chemotherapy with anthracyclines in comparison with the standard combination of CMF in breast cancer with high risk of relapse]. / Antratsiklin-soderzhashchaia ad''iuvantnaia khimioterapiia v sravnenii s klassicheskoi skhemoi CMF u bol'nykh rakom molochnoi zhelezy s vysokim riskom retsidiva.

The effectiveness of adjuvant therapy with adriablastin and doxorubicin for breast cancer has been compared to that of standard CMF. During 1985-1990, the study included 349 patients with T1-2N2M0 and T3N0-2M0 tumors; mean age--46 yrs; mean follow-up--96.7 months. Overall survival rate in the doxorubicin group was 73%, CMF--62%; relapse-free survival--62.1 and 55%, respectively. The absolute difference in overall survival rates (11%) proved barely significant (p = 0.056). However, the difference in overall survival (p < 0.05) after anthracyclines and CMF in patients with tumors T1-2N2M0 and T3N1M0 was significant and in favor of the former. As far as frequency and degree of side-effects is concerned, their patterns were practically identical in both groups, except for the significantly higher frequency of cardiotoxity and complete alopecia in doxorubicin therapy. Cardiotoxic complication rate was significantly reduced from 13.8 to 3.9% by cardioxane treatment.