Adjuvant chemotherapy with doxorubicin and cyclophosphamide in women with rapidly proliferating node-negative breast cancer.
This prospective clinical trial was designed to assess the impact of adjuvant chemotherapy in women with rapidly proliferating node-negative breast cancer. This group has been predicted to have a 5-year disease-free survival (DFS) of 70% without adjuvant chemotherapy. In this study, 449 women with rapidly proliferating breast cancer (91% measured by S-phase fraction and 9% by histochemistry) received adjuvant chemotherapy with doxorubicin/cyclophosphamide (AC) plus tamoxifen for estrogen receptor-positive or progesterone receptor-positive cancer. The 5-year DFS was 90% (+/- 2%) and the 5-year overall survival was 94% (+/- 1%). At a median follow-up of 62 months, the strategy of administering 6 cycles of AC to women with T2 N0 cancer and 3 cycles in those with smaller T1 N0 cancers appeared to eliminate tumor size as a potential prognostic factor. Adjuvant chemotherapy with AC appears effective in reducing recurrence rates for women with rapidly proliferating node-negative breast cancer.
Jones
Stephen E
SE
Charles A. Sammons Cancer Center, Baylor University Medical Center, Dallas, TX 75246, USA. steve.jones@usoncology.com
Clark
Gary
G
Koleszar
Sherry
S
Ethington
Gaby
G
Mennel
Robert
R
Paulson
Steven
S
Brooks
Barry
B
Kerr
Ronald
R
Denham
Claude
C
Savin
Michael
M
Blum
Joanne
J
Kirby
Robert
R
Stone
Marvin
M
Pippen
John
J
George
Timothy
T
Orr
Douglas
D
Knox
Sally
S
Grant
Michael
M
Peters
George
G
Savino
Daniel
D
Rietz
Charles
C
D000328:Adult; D000368:Aged; D016588:Anticarcinogenic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000401:mortality* / Q000473:pathology; D017024:Chemotherapy, Adjuvant; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000627:therapeutic use*; D018572:Disease-Free Survival; D004317:Doxorubicin / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology / Q000517:prevention & control; D011446:Prospective Studies; D015996:Survival Rate; D013629:Tamoxifen / Q000008:administration & dosage / Q000627:therapeutic use*
D016588:Anticarcinogenic Agents; D000970:Antineoplastic Agents; D013629:Tamoxifen; D004317:Doxorubicin; D003520:Cyclophosphamide