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Abstract

The treatment of breast cancer has evolved over the past 60 years. Earlier efforts, focused on achieving optimal control of local disease, ranged from radical mastectomies to lesser surgeries combined with irradiation. Surgery has been and remains an integral part of the overall therapy for this disease. With developments in therapeutic radiation technology at MD Anderson Cancer Center, the concept of breast-preserving surgery combined with irradiation became a reality in selected patients. In patients with locally advanced breast cancer, before the availability of effective systemic therapies, preoperative irradiation followed by surgery was a standard approach at this institution, and in a number of patients treated with this approach, adequate local control and long-term benefits were achieved [1] (Figs. 4.1, 4.2, and 4.3).

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References

  1. Rodger A, Montague ED, Fletcher G. Preoperative or postoperative irradiation as adjunctive treatment with radical mastectomy in breast cancer. Cancer. 1983;51:1388–92.

    Article  PubMed  CAS  Google Scholar 

  2. Hortobagyi GN, Ames FC, Buzdar AU, et al. Management of stage III primary breast cancer with primary chemotherapy, surgery, and radiation therapy. Cancer. 1988;62:2507–16.

    Article  PubMed  CAS  Google Scholar 

  3. Hortobagyi GN, Blumenschein GR, Spanos W, et al. Multimodal treatment of locoregionally advanced breast cancer. Cancer. 1983;51:763–8.

    Article  PubMed  CAS  Google Scholar 

  4. Koh EH, Buzdar AU, Ames FC, et al. Inflammatory carcinoma of the breast: results of a combined-modality approach—M.D. Anderson Cancer Center experience. Cancer Chemother Pharmacol. 1990;27:94–100.

    Article  PubMed  CAS  Google Scholar 

  5. Buzdar AU, Montague ED, Barker JL, Hortobagyi GN, Blumenschein GR. Management of inflammatory carcinoma of breast with combined modality approach—an update. Cancer. 1981;47:2537–42.

    Article  PubMed  CAS  Google Scholar 

  6. Thomas E, Holmes FA, Smith TL, et al. The use of alternate, non-cross-resistant adjuvant chemotherapy on the basis of pathologic response to a neoadjuvant doxorubicin-based regimen in women with operable breast cancer: long-term results from a prospective randomized trial. J Clin Oncol. 2004;22:2294–302.

    Article  PubMed  CAS  Google Scholar 

  7. Buzdar AU, Hortobagyi GN, Smith TL, et al. Adjuvant therapy of breast cancer with or without additional treatment with alternate drugs. Cancer. 1988;62:2098–104.

    Article  PubMed  CAS  Google Scholar 

  8. Assikis V, Buzdar A, Yang Y, et al. A phase III trial of sequential adjuvant chemotherapy for operable breast carcinoma—final analysis with 10-year follow-up. Cancer. 2003;97:2716–23.

    Article  PubMed  CAS  Google Scholar 

  9. Buzdar AU, Blumenschein GR, Gutterman JU, et al. Postoperative adjuvant chemotherapy with fluorouracil, doxorubicin, cyclophosphamide, and BCG vaccine. A follow-up report. JAMA. 1979;242:1509–13.

    Article  PubMed  CAS  Google Scholar 

  10. Buzdar AU, Singletary SE, Theriault RL, et al. Prospective evaluation of paclitaxel versus combination chemotherapy with fluorouracil, doxorubicin, and cyclophosphamide as neoadjuvant therapy in patients with operable breast cancer. J Clin Oncol. 1999;17:3412–7.

    PubMed  CAS  Google Scholar 

  11. The ATAC Trialists’ Group. Anastrozole alone or in combination with tamoxifen versus tamoxifen alone for adjuvant treatment of postmenopausal women with early breast cancer: first results of the ATAC randomised trial. Lancet. 2002;359:2131–9.

    Article  Google Scholar 

  12. Morandi P, Rouzier R, Altundag K, Buzdar AU, Theriault RL, Hortobagyi G. The role of aromatase inhibitors in the adjuvant treatment of breast carcinoma: the M. D. Anderson Cancer Center evidence-based approach. Cancer. 2004;101:1482–9.

    Article  PubMed  CAS  Google Scholar 

  13. Slamon DJ, Leyland-Jones B, Shak S, et al. Use of chemotherapy plus a monoclonal antibody against HER2 for metastatic breast cancer that overexpresses HER2. N Engl J Med. 2001;344:783–92.

    Article  PubMed  CAS  Google Scholar 

  14. Buzdar AU, Ibrahim NK, Francis D, et al. Significantly higher pathologic complete remission rate after neoadjuvant therapy with trastuzumab, paclitaxel, and epirubicin chemotherapy: results of a randomized trial in human epidermal growth factor receptor 2-positive operable breast cancer. J Clin Oncol. 2005;23:3676–85.

    Article  PubMed  CAS  Google Scholar 

  15. Buzdar AU, Valero V, Ibrahim NK, et al. Neoadjuvant therapy with paclitaxel followed by 5-fluorouracil, epirubicin, and cyclophosphamide chemotherapy and concurrent trastuzumab in human epidermal growth factor receptor 2-positive operable breast cancer: an update of the initial randomized study population and data of additional patients treated with the same regimen. Clin Cancer Res. 2007;13:228–33.

    Article  PubMed  CAS  Google Scholar 

  16. Gutterman JU, Cardenas JO, Blumenschein GR, et al. Chemoimmunotherapy of advanced breast cancer: prolongation of remission and survival with BCG. Br Med J. 1976;2:1222–5.

    Article  PubMed  CAS  Google Scholar 

  17. Vlastos G, Mirza NQ, Lenert JT, et al. The feasibility of minimally invasive surgery for stage IIA, IIB, and IIIA breast carcinoma patients after tumor downstaging with induction chemotherapy. Cancer. 2000;88:1417–24.

    Article  PubMed  CAS  Google Scholar 

  18. Ueno NT, Buzdar AU, Singletary SE, et al. Combined-modality treatment of inflammatory breast carcinoma: twenty years of experience at M. D. Anderson Cancer Center. Cancer Chemother Pharmacol. 1997;40:321–9.

    Article  PubMed  CAS  Google Scholar 

  19. Cristofanilli M, Gonzalez-Angulo AM, Buzdar AU, Kau SW, Frye DK, Hortobagyi GN. Paclitaxel improves the prognosis in estrogen receptor negative inflammatory breast cancer: the M. D. Anderson Cancer Center experience. Clin Breast Cancer. 2004;4:415–9.

    Article  PubMed  CAS  Google Scholar 

  20. Buchholz TA, Hunt KK, Amosson CM, et al. Sequencing of chemotherapy and radiation in lymph node-negative breast cancer. Cancer J. 1999;5:159–64.

    CAS  Google Scholar 

  21. Mirza NQ, Vlastos G, Meric F, et al. Ductal carcinoma-in-situ: long-term results of breast-conserving therapy. Ann Surg Oncol. 2000;7:656–64.

    Article  PubMed  CAS  Google Scholar 

  22. Buchholz TA, Tucker SL, Erwin J, et al. Impact of systemic treatment on local control for patients with lymph node-negative breast cancer treated with breast-conservation therapy. J Clin Oncol. 2001;19:2240–6.

    PubMed  CAS  Google Scholar 

  23. Mirza NQ, Vlastos G, Meric F, et al. Predictors of locoregional recurrence among patients with early-stage breast cancer treated with breast-conserving therapy. Ann Surg Oncol. 2002;9:256–65.

    Article  PubMed  Google Scholar 

  24. Meric F, Buchholz TA, Mirza NQ, et al. Long-term complications associated with breast-conservation surgery and radiotherapy. Ann Surg Oncol. 2002;9:543–9.

    Article  PubMed  Google Scholar 

  25. Meric F, Mirza NQ, Vlastos G, et al. Positive surgical margins and ipsilateral breast tumor recurrence predict disease-specific survival after breast-conserving therapy. Cancer. 2003;97:926–33.

    Article  PubMed  Google Scholar 

  26. Cabioglu N, Hunt KK, Buchholz TA, et al. Improving local control with breast-conserving therapy: a 27-year single-institution experience. Cancer. 2005;104:20–9.

    Article  PubMed  Google Scholar 

  27. Chen AM, Meric-Bernstam F, Hunt KK, et al. Breast conservation after neoadjuvant chemotherapy. Cancer. 2005;103:689–95.

    Article  PubMed  Google Scholar 

  28. Breslin TM, Cohen L, Sahin A, et al. Sentinel lymph node biopsy is accurate after neoadjuvant chemotherapy for breast cancer. J Clin Oncol. 2000;18:3480–6.

    PubMed  CAS  Google Scholar 

  29. Hunt KK, Yi M, Mittendorf EA, et al. Sentinel lymph node surgery after neoadjuvant chemotherapy is accurate and reduces the need for axillary dissection in breast cancer patients. Ann Surg. 2009;250(4):558–66.

    Google Scholar 

  30. Hortobagyi GN, Gutterman JU, Blumenschein GR, et al. Combined chemoimmunotherapy for advanced breast cancer: a comparison of BCG and levamisole. Cancer. 1979;43:1112–22.

    Article  PubMed  CAS  Google Scholar 

  31. Greenberg PA, Hortobagyi GN, Smith TL, Ziegler LD, Frye DK, Buzdar AU. Long-term follow-up of patients with complete remission following combination chemotherapy for metastatic breast cancer. J Clin Oncol. 1996;14:2197–205.

    PubMed  CAS  Google Scholar 

  32. Levine MN, Bramwell VH, Pritchard KI, et al. Randomized trial of intensive cyclophosphamide, epirubicin, and fluorouracil chemotherapy compared with cyclophosphamide, methotrexate, and fluorouracil in premenopausal women with node-positive breast cancer. National Cancer Institute of Canada Clinical Trials Group.[see comment]. J Clin Oncol. 1998;16:2651–8.

    PubMed  CAS  Google Scholar 

  33. Bull JM, Tormey DC, Li SH, et al. A randomized comparative trial of adriamycin versus methotrexate in combination drug therapy. Cancer. 1978;41:1649–57.

    Article  PubMed  CAS  Google Scholar 

  34. Ross MB, Buzdar AU, Smith TL, et al. Improved survival of patients with metastatic breast cancer receiving combination chemotherapy. Cancer. 1985;55:341–6.

    Article  PubMed  CAS  Google Scholar 

  35. Giordano SH, Buzdar AU, Smith TL, Kau SW, Yang Y, Hortobagyi GN. Is breast cancer survival improving? Cancer. 2004;100:44–52.

    Article  PubMed  Google Scholar 

  36. Buzdar AU, Blumenschein GR, Smith TL, et al. Adjuvant chemoimmunotherapy following regional therapy for isolated recurrences of breast cancer (stage IV NED). J Surg Oncol. 1979;12:27–40.

    Article  PubMed  CAS  Google Scholar 

  37. Rivera E, Holmes FA, Buzdar AU, et al. Fluorouracil, doxorubicin, and cyclophosphamide followed by tamoxifen as adjuvant treatment for patients with stage IV breast cancer with no evidence of disease. Breast J. 2002;8:2–9.

    Article  PubMed  CAS  Google Scholar 

  38. Hortobagyi GN, Yap HY, Blumenschein GR, et al. Phase II evaluation of vinblastine, methotrexate, and calcium leukovorin rescue in patients with refractory metastatic breast cancer. Cancer. 1983;51:769–72.

    Article  PubMed  CAS  Google Scholar 

  39. Legha SS, Benjamin RS, Mackay B, et al. Reduction of doxorubicin cardiotoxicity by prolonged continuous intravenous infusion. Ann Intern Med. 1982;96:133–9.

    PubMed  CAS  Google Scholar 

  40. Yau JC, Yap YY, Buzdar AU, Hortobagyi GN, Bodey GP, Blumenschein GR. A comparative randomized trial of vinca alkaloids in patients with metastatic breast carcinoma. Cancer. 1985;55:337–40.

    Article  PubMed  CAS  Google Scholar 

  41. Holmes FA, Walters RS, Theriault RL, et al. Phase II trial of Taxol, an active drug in the treatment of metastatic breast cancer. J Natl Cancer Inst. 1991;83:1797–805.

    Article  PubMed  CAS  Google Scholar 

  42. Valero V, Holmes FA, Walters RS, et al. Phase II trial of docetaxel: a new, highly effective antineoplastic agent in the management of patients with anthracycline-resistant metastatic breast cancer [see comments]. J Clin Oncol. 1995;13:2886–94.

    PubMed  CAS  Google Scholar 

  43. Green MC, Buzdar AU, Smith T, et al. Weekly paclitaxel followed by FAC as primary systemic chemotherapy of operable breast cancer improves pathologic complete remission rates when compared to every 3-week (q3wk) paclitaxel therapy followed by FAC—final results of a prospective phase III randomized trial [abstract 135]. Proc Annu Meet Am Soc Clin Oncol. 2002;21:35a.

    Google Scholar 

  44. Rivera E, Mejia JA, Arun BK, et al. Phase 3 study comparing the use of docetaxel on an every-3-week versus weekly schedule in the treatment of metastatic breast cancer. Cancer. 2008;112:1455–61.

    Article  PubMed  CAS  Google Scholar 

  45. Blum JL, Jones SE, Buzdar AU, et al. Multicenter phase II study of capecitabine in paclitaxel-refractory metastatic breast cancer. J Clin Oncol. 1999;17:485–93.

    PubMed  CAS  Google Scholar 

  46. Ingle JN, Ahmann DL, Green SJ, et al. Randomized clinical trial of diethylstilbestrol versus tamoxifen in postmenopausal women with advanced breast cancer. N Engl J Med. 1981;304:16–21.

    Article  PubMed  CAS  Google Scholar 

  47. Wells Jr SA, Worgul TJ, Samojlik E, et al. Comparison of surgical adrenalectomy to medical adrenalectomy in patients with metastatic carcinoma of the breast. Cancer Res. 1982;42:3454s–7.

    PubMed  Google Scholar 

  48. Buzdar AU, Powell KC, Legha SS, Blumenschein GR. Treatment of advanced breast cancer with aminoglutethimide after therapy with tamoxifen. Cancer. 1982;50:1708–12.

    Article  PubMed  CAS  Google Scholar 

  49. Buzdar AU, Jones SE, Vogel CL, Wolter J, Plourde P, Webster A. A phase III trial comparing anastrozole (1 and 10 milligrams), a potent and selective aromatase inhibitor, with megestrol acetate in postmenopausal women with advanced breast carcinoma. Arimidex Study Group. Cancer. 1997;79:730–9.

    Article  PubMed  CAS  Google Scholar 

  50. Nabholtz JM, Buzdar A, Pollak M, et al. Anastrozole is superior to tamoxifen as first-line therapy for advanced breast cancer in postmenopausal women: results of a North American multicenter randomized trial. Arimidex Study Group. J Clin Oncol. 2000;18:3758–67.

    PubMed  CAS  Google Scholar 

  51. Samaan NA, Buzdar AU, Aldinger KA, et al. Estrogen receptor: a prognostic factor in breast cancer. Cancer. 1981;47:554–60.

    Article  PubMed  CAS  Google Scholar 

  52. Jensen EV. Estrogen receptors in hormone-dependent breast cancers. Cancer Res. 1975;35:3362–4.

    PubMed  CAS  Google Scholar 

  53. Osborne CK, Pippen J, Jones SE, et al. Double-blind, randomized trial comparing the efficacy and tolerability of fulvestrant versus anastrozole in postmenopausal women with advanced breast cancer progressing on prior endocrine therapy: results of a North American trial.[comment]. J Clin Oncol. 2002;20:3386–95.

    Article  PubMed  CAS  Google Scholar 

  54. Hortobagyi GN, Theriault RL, Porter L, et al. Efficacy of pamidronate in reducing skeletal complications in patients with breast cancer and lytic bone metastases. Protocol 19 Aredia Breast Cancer Study Group [see comments]. N Engl J Med. 1996;335:1785–91.

    Article  PubMed  CAS  Google Scholar 

  55. Theriault RL, Lipton A, Hortobagyi GN, et al. Pamidronate reduces skeletal morbidity in women with advanced breast cancer and lytic bone lesions: a randomized, placebo-controlled trial. Protocol 18 Aredia Breast Cancer Study Group. J Clin Oncol. 1999;17:846–54.

    PubMed  CAS  Google Scholar 

  56. Buzdar AU, Ballman KV, Meric-Bernstam F, et al. Initial safety data of a randomized phase III trial comparing a preoperative regimen of FEC-75 alone followed by paclitaxel plus trastuzumab with a regimen of paclitaxel plus trastuzumab followed by FEC-75 plus trastuzumab in patients with HER2 positive operable breast cancer (ACOSOG Z1041) [abstract]. American Society of Clinical Oncology Breast Cancer Symposium 2009.

    Google Scholar 

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Correspondence to Aman U. Buzdar .

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Buzdar, A.U., Buchholz, T.A., Taylor, S.H., Hortobagyi, G.N., Hunt, K.K. (2013). Breast Cancer. In: Rodriguez, M., Walters, R., Burke, T. (eds) 60 Years of Survival Outcomes at The University of Texas MD Anderson Cancer Center. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-5197-6_4

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  • DOI: https://doi.org/10.1007/978-1-4614-5197-6_4

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