A preliminary assessment of factors associated with recurrent disease in a surgical adjuvant clinical trial for patients with breast cancer with special emphasis on the aggressiveness of therapy

Abstract

Patients (293) were randomly assigned to 3 treatment regimens following mastectomy for operable but prognostically unfavorable breast cancer: L-PAM [L-phenylalanine mustard], CFP [cytoxan, 5-fluorouracid, prednisone], or CFP with radiation therapy. For premenopausal patients an increased risk of recurrence was associated with the presence of unfavorable local signs, large number of lymph nodes involved, greater body weight, younger age, and L-PAM treatment. For the postmenopausal patients only 3 factors were associated with an increased risk of recurrent disease: large tumor size, large number of lymph nodes involved, and inner/central location of the primary lesion. Specifically, the treatment employed has shown no effect. Of particular importance is the fact that for neither group of patients does this experience presently demonstrate clear association of recurrent disease with the level of drug dose administered. Evidence suggests that, although patients who experience little or no myelosuppression have significantly worse disease-free intervals than patients who experience moderate or severe myelosuppression, there is no benefit for severe myelosuppression over moderate myelosuppression.