title: Early recurrence in favorable stage II breast cancer--which approach is the best?
abstract: OBJECTIVE
  Changing the sequence of therapeutic options in stage II breast cancer: first, a core biopsy, followed by the evaluation of the tumoral markers, adaptation of the chemotherapy scheme and finally, surgical approach. Thus would be possible to improve the hope of life in some stage II breast cancer patients, in whom survival is poorer than in some stage III patients.
  
  
  METHODS
  144 patients in stage II breast cancer were included in this study, over a period of 5 years (2000-2004). In all these patients the first therapeutic option was surgery (radically modified mastectomy type Madden), followed by systemic chemotherapy-FAC or FEC, 6 cycles, and finally Tamoxifen.
  
  
  RESULTS
  34 out of them developed metastases in a period between 6 and 72 months, most of them in the first 26 months; 25 out of these 34 didn't have metastases in the axillary lymph nodes, and in 18 patients estrogen--and progesterone--receptors were highly positive. HER 2 neu was negative or low expressed in patients with metastases. CD 34 wasn't evaluate in the whole group.
  
  
  CONCLUSIONS
  Early onset of metastases in the studied patients, in whom tumoral aggressiveness markers were not obvious, impose the evaluation of the angiogenesis markers and, when positive, chemotherapy as the first therapeutic option.
authors.affiliation: School of Medicine, Gr.T. Popa University of Medicine and Pharmacy Iaşi.
authors.forename: C
authors.initials: C
authors.lastname: Diaconu
authors.forename: Camelia
authors.initials: C
authors.lastname: Chifu
authors.forename: C
authors.initials: C
authors.lastname: Cosman
authors.forename: Roxana
authors.initials: R
authors.lastname: Livadariu
authors.forename: Irina
authors.initials: I
authors.lastname: Florea
authors.forename: L
authors.initials: L
authors.lastname: Miron
authors.forename: C
authors.initials: C
authors.lastname: Dogaru
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000097:blood; D001706:Biopsy; D001943:Breast Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D002471:Cell Transformation, Neoplastic; D005260:Female; D006801:Humans; D015411:Mastectomy, Modified Radical; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D009367:Neoplasm Staging; D012189:Retrospective Studies; D016019:Survival Analysis; D013629:Tamoxifen / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D018931:Antineoplastic Agents, Hormonal; D014408:Biomarkers, Tumor; D013629:Tamoxifen