Therapy for inflammatory breast cancer: impact of doxorubicin-based therapy.

Abstract

BACKGROUND:

Inflammatory breast cancer (IBC) carries an ominous prognosis. Before 1988, women with IBC at our institution were treated with neoadjuvant cyclophosphamide, methotrexate, and 5-fluorouracil (CMF) with or without vincristine and prednisone (CMF/VP). After 1988, women with IBC were treated with cyclophosphamide, doxorubicin, and 5-fluorouracil (FAC). This study compares these two regimens with regard to response and survival.

METHODS:

The records of all women presenting between January 1973 and December 1991 with a stage IIIB (T4d, any N, MO) breast cancer with proven dermal lymphatic invasion by tumor cells were reviewed retrospectively.

RESULTS:

The study comprised 38 women; 28 received CMF (22 CMF, 6 CMF/VP), and 10 received FAC. The overall response rate to induction chemotherapy in the CMF/VP group was 57% (40% PR, 17% CR), and 100% (60% PR, 40% CR) in the FAC group. The median overall survival for women receiving CMF/VP was 18 months compared with 30 months for women receiving FAC (p = 0.02). The median disease-free survivals for the CMF/VP and FAC groups were 6 and 24 months, respectively (p < 0.001). When comparing responders and nonresponders with CMF/VP induction therapy, the responders had a significantly longer overall median survival (24 versus 10 months) (p < 0.001) and disease-free median survival (8 versus 2 months) (p < 0.001). All of the five patients remaining alive received FAC with 80% (four of five) having a complete response. These four patients subsequently underwent mastectomy and radiation.

CONCLUSION:

This study suggests that a doxorubicin-containing chemotherapy regimen improves overall and disease-free median survivals when compared with the previously used CMF combination in the treatment of IBC. A favorable response to induction chemotherapy also appeared to be associated with an improved survival.

• Authors: R L Bauer, E Busch, E Levine, S B Edge
• Journal: Annals of surgical oncology (Ann Surg Oncol) Vol. 2 Issue 4 Pg. 288-94 (Jul 1995) ISSN: 1068-9265 [Print] United States
• PMID: 7552616 (Publication Type: Comparative Study, Journal Article, Research Support, U.S. Gov't, P.H.S.)

Chemical References

• Doxorubicin

Topics

• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Biopsy
• Breast Neoplasms (drug therapy, mortality, pathology)
• Disease-Free Survival
• Doxorubicin (therapeutic use)
• Female
• Humans
• Inflammation (drug therapy, mortality, pathology)
• Middle Aged
• Retrospective Studies
• Survival Rate