Locally advanced breast cancer: a problem for a combined approach

ABSTRACT

One hundred sixty seven evaluable cases with non-inflammatory locally advanced breast cancer [Stage III b] were retrospectively studied for the results of treatment, pattern of relapse and survival at a follow up period of 2 years. The patients were collected at Kasr Elaini centre of Radiation Oncology and Nuclear Medicine over a period of 9 years [1979-1987]. The patients were managed by different single and combined treatment modalities [Non protocol]. At 2 years, patients treated by locoregional treatment approaches [Surgery and/or radiotherapy] had a very poor relapse free survival [23%] which improved to 41% when 6-9 courses of chemotherapy were added after locorgional treatment [P<0.05]. best relapse free survival [59%] was obtained when intial [Neoadjuvant] chemotherapy [adriamycin based regimen] was used prior to surgery and radiotherapy. When radiotherapy was used to control the primary disease; doses above 65 Gy could achieve 78% local control at 2 years versus 30% in doses below 60 Gy [P< 0.05]. The role of surgery and its timing as well as extent were discussed concluding that prior chemotherapy was of great benefit