Primary chemotherapy with cyclophosphamide, methotrexate, and 5-fluorouracil in operable breast carcinoma

Authors

  • Catalina Falo M.D.,

    Corresponding author
    1. Department of Medical Oncology, Unitat Funcional De MAMA, Institut Català d'Oncologia, Hospital Duran i Reynals, Hospital Universitari I, Universitari de Bellvitge, Barcelona, Spain
    • Unitat funcional de MAMA, Institut Català d'Oncologia. Hospital Duran i Reynals, Hospital Universitari de Bellvitge (Barcelona), Avda Gran Via s/n, Km 2.7m, 08907 L'Hospitalet, Barcelona, Spain
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    • Fax: (011) 34-93-2607727

  • Abelardo Moreno Ph.D.,

    1. Department of Pathology, Unitat Funcional De MAMA, Institut Català d'Oncologia, Hospital Duran i Reynals, Hospital Universitari I, Universitari de Bellvitge, Barcelona, Spain
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  • Enrique Benito Ph.D.,

    1. Department of Gynecology, Unitat Funcional De MAMA, Institut Català d'Oncologia, Hospital Duran i Reynals, Hospital Universitari I, Universitari de Bellvitge, Barcelona, Spain
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  • Belen Lloveras Ph.D.,

    1. Department of Pathology, Unitat Funcional De MAMA, Institut Català d'Oncologia, Hospital Duran i Reynals, Hospital Universitari I, Universitari de Bellvitge, Barcelona, Spain
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  • Mar Varela B.S.,

    1. Department of Biology, Unitat Funcional De MAMA, Institut Català d'Oncologia, Hospital Duran i Reynals, Hospital Universitari I, Universitari de Bellvitge, Barcelona, Spain
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  • Jose Ma Serra M.D.,

    1. Department of Plastic Surgery, Unitat Funcional De MAMA, Institut Català d'Oncologia, Hospital Duran i Reynals, Hospital Universitari I, Universitari de Bellvitge, Barcelona, Spain
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  • Luis Prieto M.D.,

    1. Department of Radiology, Unitat Funcional De MAMA, Institut Català d'Oncologia, Hospital Duran i Reynals, Hospital Universitari I, Universitari de Bellvitge, Barcelona, Spain
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  • Diego Azpeitia M.D.,

    1. Department of Surgery, Unitat Funcional De MAMA, Institut Català d'Oncologia, Hospital Duran i Reynals, Hospital Universitari I, Universitari de Bellvitge, Barcelona, Spain
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  • Agustin Escobedo Ph.D.

    1. Department of Medical Oncology, Unitat Funcional De MAMA, Institut Català d'Oncologia, Hospital Duran i Reynals, Hospital Universitari I, Universitari de Bellvitge, Barcelona, Spain
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Abstract

BACKGROUND

Primary chemotherapy (PC) is becoming an accepted practice to treat large tumors to avoid mastectomies and as a surrogate of outcome.

METHODS

A series of 305 patients with tumors > 3 cm with T2–3N0–1M0 classification were treated with a multimodal approach that consisted of 3 courses of primary cyclophosphamide, methotrexate, and 5-fluorouracil (CMF) followed by appropriate local treatment and 3 more courses of CMF or 4 courses of doxorubicin. Response was assessed by mammography.

RESULTS

The overall response rate was 48% (a 3% pathologic complete response rate). Conservative surgery was achieved in 79.64% of the patients with a low rate of local disease recurrences (5%). Toxicity was minimal. With a median follow-up of 104 months, the 8-year disease-free survival (DFS) rate was 57.63% and the 8-year overall survival (OS) was 67.65%. The DFS and OS rates for patients with a clinical response were significantly longer, i.e., 70% (P = 0.0048) and 90% (P = 0.0042), respectively.

CONCLUSIONS

PC with CMF was feasible. A high rate of breast-conservative surgery was achieved. The current results stressed the value of PC to increase conservative surgery and as a predictor of outcome. Cancer 2005. © 2005 American Cancer Society.

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