Induction Chemotherapy for Breast Cancer: A case control study

Jeong, Chang Wook; Sohn, Chang Yong; Kim, You Sah

Abstract

PURPOSE: Preoperative chemotherapy has been extensively used in inoperable or locally advanced breast cancer to achieve tumor reduction and, thus, to facilitate extensive surgery. METHODS: A hospital-based case-control study was carried out to identify the effect of induction chemotherapy on breast cancer. 49 patients with breast cancer were treated with initial chemotherapy between October 1986 and June 1998. 43 patients were treated with three courses of the CMF regimen (cyclophosphamide and metho trexate and 5-fluorouracil), four patients with three courses of the FEC regimen (5-fluorouracil, epirubicine and cyclophosphamide), two patients with three courses of the FAC regimen (5-fluorouracil, adriamycin and cyclophosphamide). RESULTS: The response, rate to induction chemotherapy was 83.7% including 4% complete response, and there were no significant differences in response rates according to the chemo therapy regimen. At a mean follow-up of 51.9 months, recurrence and distant metastasis were observed in 32.7% and 18.4% of the patients, respectively. The five-year disease- free survival rate of the patients in the induction group was lower than that of the patients in the control group (35.5+/-8.7% versus 59.9+/-9.0%), but the five-year overall survival rate in the induction group was higher than control group (88.7 5.3% versus 76.9+/-6.6%). CONCLUSIONS: Preoperative induction chemotherapy is a useful treatment option for patients with locally advanced breast cancer. Also, there is an improvement in the five-year overall survival rate for patients in the induction chemotherapy group compared with that for patients in the age- and stage-controlled postoperative adjuvant chemotherapy group.