Primary chemotherapy and radiation therapy for locally advanced carcinoma of the breast: 15 years of experience

• Published in: Breast (Edinburgh) Vol. 6; no. 5; pp. 266 - 270
• Main Authors: McLaren, D.B., Morrey, D., Keen, C.W., Webster, D.J.T., Barrett-Lee, P.J.
• Format: Journal Article
• Language: English
• Published: Elsevier Ltd 01-10-1997
• ISSN: 0960-9776; 1532-3080
• DOI: 10.1016/S0960-9776(97)90002-3

The data on 91 patients (aged 30–78 years) with inoperable locally advanced breast cancer treated by primary chemotherapy and radiation therapy from 1980 to 1995 in the Breast Oncology Unit, Cardiff were analysed. Four chemotherapy regimens were used: 1) doxorubicin 40 mg/m
2 + vincristine 1 mg/m
2 (AV), three cycles; 2) mitozantrone 14 mg/m
2 (MZ), three cycles; 3) cyclophosphamide 600 mg/m
2, methotrexate 40 mg/m
2, 5-fluorouracil 600 mg/m
2 (CMF), six cycles; 4) cyclophosphamide 600 mg/m
2, adriamycin/epirubicin 50 mg/m
2, 5-fluorouracil 600 mg/m
2 (CAF/CEF), six cycles. The breast and glandular areas were irradiated to 40–50 Gy in 15–25 fraction (+/-5–10 Gy boost in two-to-five fractions. The overall response rate to chemotherapy was 61% (95% confidence interval 51–71%) with 13% CR (6–20%). Thirteen patients underwent mastectomy for operable persistent disease. Ten patients had uncontrolled inoperable local disease after primary therapy; 61 patients have relapsed, 69% due to metastases, (15% synchronous with local relapse), 31% local failure only. The overall 2−, 5− and 10-year survival rates are 54% (42–66%), 28% (16–40%) and 11% (1–21%) respectively. These results confirm that metastasis rather than local failure dictates the poor outcome in these patients and that breast conservation can be achieved.