SAN ANTONIO--Primary chemotherapy successfully converted 29 of
47 mastectomy candidates to breast conservation in a French study
reported at the San Antonio Breast Cancer Symposium.
All the patients had infiltrating carcinoma of the breast. Each
woman had a single tumor between 4 cm and 7 cm. No patient had
a lymph node larger than 2.5 cm in diameter, and none had inflammatory
signs, reported Beatrice Weber, MD, an oncologist at Centre Alexis
Vautrin, Vandoeuvre-les-Nancy, France.
The mean age of the women was 42, and 36 were premenopausal. Histology
was ductal carcinoma in 38 patients.
In an effort to avoid mastectomy, the women underwent three or
four cycles of combination chemotherapy after initial biopsy:
doxorubicin or epirubicin on day 1, cyclophosphamide over 4 days,
and fluorouracil over 4 days.
Patients who had tumor responses that permitted lumpectomy had
an additional two or three cycles of chemotherapy prior to surgery.
Chemotherapy continued after surgery, for a total of nine cycles,
followed by radiation therapy.
As assessed by reduction in tumor size, 30 patients had significant
responses to the chemotherapy. With respect to nodal status, 31
had significant responses, Dr. Weber said in her poster presentation.
At a median follow-up of 48 months, 27 of 29 patients treated
conservatively remained alive, including all 14 who had positive
lymph nodes, compared with 14 of 18 mastectomy patients still