Breast cancer research and treatment
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Breast Cancer Res. Treat. · Jan 1996
Variation in staging and treatment of local and regional breast cancer in the elderly.
Few studies of practice variation in the management of early breast cancer for elderly women have examined the process of care in depth. This study evaluated the effects of age and other factors on surgical staging techniques and treatment. ⋯ Younger age was most consistently associated with staging and the use of chemotherapy in this cohort of elderly breast cancer patients. Based on the reported initial treatment plan, hormonal therapy was infrequently used and information from axillary lymph node assessment was used to stratify treatment. Although the low use of adjuvant hormonal therapy in elderly women may compromise survival, neither comorbid nor socioeconomic factors as measured in this study explained this practice pattern.
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Breast Cancer Res. Treat. · Jan 1996
Time distribution of the recurrence risk for breast cancer patients undergoing mastectomy: further support about the concept of tumor dormancy.
To gather information on metastatic growth from the time-distribution of first treatment failure in breast cancer patients undergoing mastectomy alone. ⋯ The multipeak hazard curve suggests that the process resulting in overt clinical metastases may have discrete features. Primary tumor size could affect in different ways early and late metastases, while axillary node status should be related to the risk level, not to the risk pattern, and menopausal status does not seem to significantly affect the hazard distribution. Moreover, contralateral breast tumors, occurring at constant risk throughout the time, should be considered as second primary cancers. These findings could be reasonably explained by a tumor dormancy hypothesis, which assumes that micrometastases may be in different biological steady states, most of which do not imply tumor growth. Tumor or microenvironment changes could induce metastatic growth after given mean transition times from surgery and originate a discrete pattern of the hazard function.
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Breast Cancer Res. Treat. · Jan 1996
High-dose chemotherapy with autologous stem cell rescue in breast cancer.
Because metastatic breast cancer is a lethal disease despite some responsiveness to systemic chemotherapy, high-dose chemotherapy with autologous stem cell rescue is being utilized with increasing frequency. This analysis was undertaken to determine the outcome for such patients treated with intensive chemotherapy between 1989-1994, at the Hoag Cancer Center in Newport Beach, CA. ⋯ Modifications made in the program, including selection of patients responsive to induction chemotherapy, transfusion of peripheral blood stem cells, implementation of hematopoietic colony stimulating factors, and use of tandem intensive treatments has been associated with a low rate of acute morbidity and encouraging survival rates.
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Breast Cancer Res. Treat. · Jan 1995
ReviewCurrent status of Taxotere (docetaxel) as a new treatment in breast cancer.
Therapy for advanced breast cancer has not improved significantly in recent years, remaining strictly palliative in nature and intent. One approach to increase the effectiveness of the treatment is the introduction of active new drugs. Taxotere (docetaxel) is a taxoid derivative isolated from the needles of the European yew, Taxus baccata. ⋯ Grades III and IV neutropenia without major infection, and grades I and II skin toxicity, were frequently observed adverse events. A fluid retention syndrome (chronic cumulative and non life-threatening toxicity) has been noted in patients treated with Taxotere. Methods for controlling fluid retention--dose reduction to 75 mg/m2 (which has little effect) or routine premedication from the start of treatment--are currently being studied.
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Breast Cancer Res. Treat. · Jan 1992
Proportional hazards and recursive partitioning and amalgamation analyses of the Southwest Oncology Group node-positive adjuvant CMFVP breast cancer data base: a pilot study.
Several putative prognostic factors have been identified in node-positive breast cancer patients, but their importance needs to be clarified in a uniformly treated population. The objectives of this investigation were: 1) to describe the characteristics of a uniformly treated node-positive data base; 2) to use proportional hazards (Cox) and recursive partitioning and amalgamation (RPA) multivariate models to assess the importance of potential prognostic factors for disease-free and for overall survival; and 3) to define prognostic groups with different disease-free survival and survival outcomes with RPA. A data base of 768 node-positive patients enrolled on 1-year adjuvant CMFVP arms of four SWOG trials was formed. ⋯ In the RPA for disease-free survival, best node cutoffs differed by menopausal status, tumor size was important only in postmenopausal patients with few positive nodes, and age at menopause emerged as an independent predictor of recurrence potential. And, the RPA for survival showed that node cutoffs differed according to ER level. Thus, these analyses underscore the value of simple, clinically available prognostic factors and suggest the possible need to reconsider the definition of good and poor risk patient groups in future adjuvant trial design.