[Postoperative hormone therapy of breast cancer (analysis of overall survival)]. / Posleoperatsionnaia gormonoterapiia raka molochnoi zhelezy (analiz obshchei vyzhivaemosti)

A third series of randomized evaluation of postoperative (adjuvant) hormone therapy (tamoxifen, sinestrol and orimeten) was carried out in breast cancer patients. The study group involved 1.332 reproductive and postmenopausal females with stage I-III tumors. The investigation established quite a range of 10-year survival evidence versus stage and reproductive status; however, no significant differences were recorded in either of the groups. Untoward side-effects were more frequent when treating with diethyl-stilbestrol (over 30%) than with tamoxifen (3.5%). No significant differences were registered in five-year total and recurrence-free survival in the treatment with orimeten or tamoxifen.

[Preliminary results of the Russia (St.Petersburg)/WHO program for the evaluation of the effectiveness of breast self-examination]. / Promezhutochnye rezul'taty programmy Rocciia (Sankt-Peterburg)/VOZ po otsenke éffektivnosti samoobsledovaniia molochnykh zhelez.

Although an absolute difference of 10% (65,4 vs. 54,9%) in 5- and 9-year survival in breast cancer patients was recorded between the self-examination and control groups a large-scale randomized population-controlled study of 122,471 females has failed to provide significant differences (Log-rank - 0,774, p > 0.05). No significant decrease in mortality was observed in the self-examination group as compared with the untrained controls. As a result of providing more information to the population on risk factors. twice as many of the trained females consulted oncologists. Also, the number of early detection of breast tumor (T1-2NOMO) in both groups was 1,5-2,5 times that recorded elsewhere. Since 3,55 per 1,000 patients with breast tumors per year, aged 50-59, died of cardio-vascular disease, i.e. 3,1 times the expected 1,16 per 1,000, more attention should be focused on timely diagnosis and treatment of concomitant cardio-vascular pathology.

[Breast-preserving (conservative) therapy of breast cancer]. / Organosokhraniaiushchee (konservativnoe) lechenie raka molochnoi zhelezy.

Conservative surgery (sectoral or segmental + axillary dissection) was performed in 278 patients with breast cancer (T1-2N0M0) at the Institute Clinic in 1990-1995. Following thorough morphological examination. 148 patients (53.2%) were selected to form a clinical study group for an investigation of the role of postoperative radiotherapy in the conservative treatment of breast cancer. Two groups-irradiation of the remaining breast tissue and controls-were formed on the basis of randomized data. Follow-up continued 3-60 months (average duration-37.7 months). Local recurrence was detected in 3 out of 73 (4.2%) patients of group I. A similar relapse was detected in 6 out of 75 (8.0%) patients of group II. No significant difference in total survival rates in the two groups was observed (97.3 and 96.0%; p > 0.05).

Clinical trials on adjuvant chemotherapy for breast cancer.

Clinical trial initiated in 1975 at the Petrov Research Institute of Oncology (Leningrad) included 1228 patients with breast cancer Stages I, II, and III. Adjuvant chemotherapy in patients with Stages I-II (P T0-2N0-1M0) leads to decrease in mortality rate by 24.3% in the case of monochemotherapy (thiotepa, six courses, 200 mg each course) and 32.4% in the case of polychemotherapy (thiotepa, methotrexate, 5-fluorouracil [TMF], cyclophosphamide, methotrexate, 5-fluorouracil [CMF], six course). There is a trend to higher (by 7.8%-9.8% versus control) rates of adjusted survival in the groups of patients with relatively early stages of breast cancer (P T0-2N0M0) subjected to adjuvant mono- and polychemotherapy. In the group of breast cancer patients (P T0-2N0-1M0) who received adjuvant polychemotherapy (TMF, CMF schemes) the survival rates are higher by 12.0%-16.6% than in the control group during the sixth, seventh, and eighth years of the follow-up. Favorable effect of adjuvant chemotherapy manifested by diminished mortality rate and prolonged survival was statistically significant only in the group of patients younger than 50 years.