Combined modality approach in breast cancer with isolated or multiple metastases

Abstract

A total of 136 patients with isolated recurrence of breast cancer received regional therapy (surgery and/or irradiation) followed by combination chemotherapy with fluorouracil, doxorubicin and cyclophosphamide (FAC). The disease-free survival of the group receiving FAC was compared to that of a historical control group treated with only regional therapy. The median disease-free interval between the 1st and 2nd recurrence for the control group was 9 mo., and for the patients receiving FAC, 38 mo. (P < 0.01). The median survivals from 1st recurrence for the control and the FAC groups were 40 mo. and 60 mo., respectively (P < 0.02). In addition, 20 selected patients with multiple sites of metastasis or bulky isolated recurrence were initially treated with FAC chemotherapy; following complete or partial response with chemotherapy, these patients had regional therapy at the known sites of metastases. At a median follow-up time of 54 mo., 9/29 patients (45%) have remained in complete remission. Combined modality approach signficiantly prolongs the disease-free survival of patients with isolated recurrences of breast cancer; in selected patients with multiple metastases, this approach results in extended complete remissions.