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(Drug information on doxorubicin) or epirubicin on day 1, cyclophosphamide(Drug information on cyclophosphamide) over 4 days, and fluorouracil(Drug information on 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 alive.