Preoperative 5-fluorouracil and radiation therapy for locally advanced breast cancer.
BACKGROUND
Fifteen percent of breast cancer patients present with large tumors involving skin or chest wall. Often, surgery with primary wound closure is impossible. We used neoadjuvant chemoradiation in locally advanced breast cancer patients, in hopes of increasing resectability.


METHODS
Eligible patients had locally advanced breast cancer deemed unresectable with primary wound closure. Patients received 8 weeks of infusional 5-fluorouracil (5-FU) 200 mg/m2 per day and radiation therapy to 50 Gy. Patients rendered resectable underwent modified radical mastectomy (MRM) followed up by chemotherapy.


RESULTS
Of 30 evaluable patients, 73% had an objective clinical response. All were able to undergo MRM with primary wound closure; 63% had residual disease, 20% had minimal microscopic disease, and 17% had complete pathologic response. Treatment-related toxicity was minimal. Surgical morbidity was not increased.


CONCLUSIONS
Infusional 5-FU with concomitant radiotherapy is well tolerated and effective at producing shrinkage in the majority of patients, converting inoperable breast cancer to easily resectable disease.
Skinner
K A
KA
Department of Surgery, University of Southern California School of Medicine and the Kenneth Norris Comprehensive Cancer Center, Los Angeles 90033, USA.
Dunnington
G
G
Silberman
H
H
Florentine
B
B
Spicer
D
D
Formenti
S C
SC
D000328:Adult; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery*; D017024:Chemotherapy, Adjuvant; D005260:Female; D005472:Fluorouracil / Q000627:therapeutic use*; D006801:Humans; D015411:Mastectomy, Modified Radical; D008875:Middle Aged; D011300:Preoperative Care; D018714:Radiotherapy, Adjuvant; D016896:Treatment Outcome
D000964:Antimetabolites, Antineoplastic; D005472:Fluorouracil