The Role of Surgery in the Combined Treatment of Locally Advanced Breast Cancer

Canavese, Giuseppe; Catturich, A.; Battistini, G; Caroti, C.; Pronzato, P.; Gardin, G.; Amoroso, Domenico; Bertelli, G.; Conte, Pierfranco; Tomao, Silverio

doi:10.1159/000226749

Cited by 5 publications

(4 citation statements)

References 7 publications

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“…Local recurrence rates of 20% or less can be achieved [9, 14, 41, 42, 44, 48, 54, 62]. In contrast to Haagensen’s paper, survival rates of 50% at 5 years or more are now becoming the norm [9, 13, 14, 24, 26, 27, 41, 42, 44, 46, 48, 54, 60, 62, 67, 68, 69].…”

Section: Discussionmentioning

confidence: 99%

“…Abdel-Wahab et al [48] 42 93 88% at 3 years OS Canavese et al [26] 60 70 71% at 4 years OS Hortobagyi et al [14] b 176 79-100 33%-71% at 5 years DFS Perez et al [42] 81 80 32% at 5 years DFS Karlsson et al [62] 128 80 36% at 5 years DFS Merajver et al [31] 89 72-77 54% at 5 years OS Morrell et al [23] 55 89 63% at 5 years OS Brito et al [11] 70 81 31% at 10 years OS Graham et al [67] 175 78-80 20%-31% at 10 years DFS Olson et al [41] 164 85 43% at 10 years OS OS: overall survival; DFS: disease-free survival. Ranges given in local control and survival columns reflect different systemic treatment arms in the same study.…”

Section: Surgery and Radiotherapymentioning

confidence: 99%

“…Some investigators have claimed that intensive chemotherapy can restore most patients with LABC to a status of “no evidence of disease” [25]. Despite this clinical efficacy, pathologic examination of mastectomy specimens shows that complete pathologic responses occur in less than 10% of patients treated in this way [14, 24, 26, 27, 28, 29, 30, 31]. Even after added radiotherapy, the rate of pathologically complete response is less than 20% [32, 33, 34].…”

Section: Chemotherapymentioning

confidence: 99%

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Locally Advanced Breast Cancer inDeveloping Countries: The Place of Surgery

Apffelstaedt

2003

World j. surg.

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Most breast cancer patients in developing countries still present with locally advanced breast cancer (LABC). Because surgery is the most widely available treatment modality, we examine its place in the management of LABC. Historically, single local treatment modalities have had disappointing results, and multimodality therapy has become the norm for combatting LABC. Combining surgery and radiotherapy will lead to superior local control rates. Surgery should precede radiotherapy. Preoperative systemic treatment-with the possible exception of cyclophosphamide, methotrexate, 5-fluououracil (CMF) chemotherapy-does not influence surgical complication rates. Hormonal therapy is understudied and underutilized; its benefits become apparent only in prolonged follow-up. Sequencing of local and systemic treatments does not influence oncologic outcome, but failure to respond to preoperative systemic therapy may identify patients with a poor prognosis. With multimodality management including hormonal therapy, chemotherapy, radiotherapy, and surgery, local control rates of more than 80% and 5-year survival rates of more than 50% have become the norm.

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Section: Discussionmentioning

confidence: 99%

Section: Surgery and Radiotherapymentioning

confidence: 99%

Section: Chemotherapymentioning

confidence: 99%

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Locally Advanced Breast Cancer inDeveloping Countries: The Place of Surgery

Apffelstaedt

2003

World j. surg.

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“…2,[13][14][15] In the multidisciplinary treatment for locally advanced breast cancer including inflammatory breast cancer, IAIC has attracted much attention, especially in Japan, as an induction therapy instead of systemic chemotherapy. 2,[13][14][15] In the multidisciplinary treatment for locally advanced breast cancer including inflammatory breast cancer, IAIC has attracted much attention, especially in Japan, as an induction therapy instead of systemic chemotherapy.…”

Section: Discussionmentioning

confidence: 99%

Histological Evaluation of the Effects of Intraarterial Chemotherapy for Advanced Breast Cancer: A Long-term Followup Study with Respect to the Survival Rate

Toda¹,

Hirata²,

Sato³

et al. 1998

Surgery Today

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To evaluate the effects of intraarterial infusion chemotherapy (IAIC) for advanced breast cancer, we examined the grade of histological responses of preoperative IAIC on tumors at the time of operation and estimated the patients' prognoses for 19 years. IAIC was done preoperatively using timely epochal anticancer drugs on 105 patients with locally advanced (Stage IIIa, IIIb) and metastatic (Stage IV) breast cancer. The survival rate of the Stage IIIb patients who showed a good histological response (Grade IIb< or =) to IAIC was 68.1% for 5 years, and 62.4% for 10 years, respectively. This was in contrast to that of the patients classified as Stage IIIb who showed a poor histological response (Grade IIa> or =) to IAIC. On the other hand, there was no significant difference in the survival rates between the Stage IIIa and IV patients with good and poor histological responses to IAIC. However, the findings showed that a good histological response to IAIC reflected a prolonged survival while the Stage IIIb and IV patients acquired a "down clinical staging" by IAIC. These results strongly suggest that IAIC thus appears to be a useful modality in the multidisciplinary treatment of advanced breast cancer, especially for Stage IIIb patients.

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