Annals of Surgical Oncology

, Volume 2, Issue 4, pp 288–294

Therapy for inflammatory breast cancer: Impact of doxorubicin-based therapy

  • Ronald L. Bauer
  • Erna Busch
  • Ellis Levine
  • Stephen B. Edge
Original Articles

DOI: 10.1007/BF02307059

Cite this article as:
Bauer, R.L., Busch, E., Levine, E. et al. Annals of Surgical Oncology (1995) 2: 288. doi:10.1007/BF02307059

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.

Key Words

BreastAdvancedChemotherapy

Copyright information

© The Society of Surgical Oncology, Inc 1995

Authors and Affiliations

  • Ronald L. Bauer
    • 1
  • Erna Busch
    • 1
  • Ellis Levine
    • 2
  • Stephen B. Edge
    • 1
  1. 1.From the Department of Surgical OncologyRoswell Park Cancer InstuteBuffaloUSA
  2. 2.the Department of Medical OncologyRoswell Park Cancer InstituteBuffaloUSA
  3. 3.Division of Breast SurgeryRoswell Park Cancer InstituteBuffaloUSA