Clinical and therapeutic results in a series of 41 patients treated for inflammatory cancer of the breast lend emphasis to the selection criteria to be included in a short (approximately two months) clinical history to complement Haagensen's criteria. Chemotherapy improved the previous very poor results obtained in this condition. Survival after surgery and radiotherapy were less than 5% at five years, and this is compared with the prognosis in the series study. However, these results are still only fair in absolute terms and there is still no currently available alternative solution to attempt to achieve a marked improvement in the course of the lesion.

Acute Disease↗

PubMedDate not supplied

Mitoxantrone combined with vincristine, cyclophosphamide and fluorouracil for advanced breast cancer. A study of short-term response rate.

50 patients with advanced breast cancer were treated with the combination of Mitoxantrone 10mg/m2 IV day 2, 5-Fluorouracil 400mg/m2 IV and Cyclophosphamide 300mg/m2 IV day 3, 4, 5, 6 of each monthly cycle. 49 patients are evaluable for toxicity and 47 for efficacy after three months of treatment. Hematologic toxicity was substantial and dose-limiting, with one toxic death early in the trial. Other toxicities were moderate and manageable in this short-term study. The response rate after three cycles was 53% +/- 14% with 4 complete remissions, 21 partial remissions, 16 stable disease and 6 progressions. Using the fixed response rate hypothesis of Gehan generalised by Lee and Wesley, with an expected response rate of 60% consistent with the reported response rate of advanced breast cancer to Adriamycin containing regimens, we conclude that the combination studied is not less efficient for the induction of remissions in advanced breast cancer than comparable combinations with Adriamycin. As there is now substantial experimental and clinical evidence of reduced toxicity, mainly on the cardiac muscle, of Mitoxantrone as compared to Adriamycin, we feel that the routine substitution of the latter by the former in chemotherapy for advanced breast cancer is justifiable.

Adult↗

PubMedDate not supplied

[Covering of substantial loss of substance in breast cancer with local complications. Apropos of 57 cases].

On the basis of 57 cases, the authors report their experience in the repair of substantial losses of tissue caused by surgical resection of local neoplastic recurrences of breast cancers, in particular those situated in irradiated zones, and in certain cases by surgical resection of locally developing and neglected neoplastic lesions. Three types of operation are practised and the techniques involved in these are reviewed: Omentoplasty according to Kiricuta (35 cases), Musculocutaneous flap of the latissimus dorsi muscle (10 cases), Cutaneous and cutaneo-glandular flaps (12 cases). The choice of technique is based on the local conditions and the evolutivity of the neoplastic disease. The results obtained at the local level are then analysed in function of the lesions treated (comparing in particular irradiated and non-irradiated zones), the area resected and the type of operation chosen. Such an analysis reveals that the pedicled omentum flap, owing to its high trophicity, its ease of mobilization and its large size, constitutes the most reliable and effective technique in the treatment of extensive radionecroses. Less substantial losses of tissue may benefit appreciably from the use of a latissimus dorsi musculocutaneous flap, characterized by easy mobilization and high vitality and providing a covering of quality at the cost of a relatively unobtrusive scar. The use of cutaneous flaps can be advocated only for small areas and should be avoided in irradiated zones.

Adult↗

PubMedDate not supplied