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New strategies in locally advanced breast cancer

  • Chapter
Surgical Oncology

Part of the book series: Cancer Treatment and Research ((CTAR,volume 90))

Abstract

A combined modality approach, with the integration of systemic chemotherapy and/or hormonal therapy with surgery and irradiation, is considered the standard of care in the treatment of locally advanced breast cancer. Since the mid-1970s, patients with primary breast cancers larger than 5 cm in diameter (T3, stage IIB), with skin or chest wall involvement (T4, stage IIIB), or with matted or fixed axillary lymph nodes (N2, stage IHA), have been treated at The University of Texas M.D. Anderson Cancer Center with a doxorubicin-based combination chemotherapy for three to four cycles prior to local therapy, which is followed by completion of systemic therapy and irradiation [1]. Because the histological response of tumor shrinkage within the surgical specimen is a more reliable prognostic indicator than clinical response [2,3], patients with residual tumor greater than 1 cm3 in size are crossed over to a different chemotherapy regimen after surgery. Currently, a promising alternative is the drug paclitaxel (Taxol), which has been shown to be effective even in tumors that are anthracycline resistant [4,5]. However, it is still unclear whether this approach will significantly improve overall survival rates.

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  1. S. Eva Singletary
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  2. Kapil Dhingra
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  3. Di-Hua Yu
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Editors and Affiliations

  1. M.D. Anderson Cancer Center, The University of Texas, Houston, Texas, USA

    Raphael E Pollock M.D., Ph.D.

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Singletary, S.E., Dhingra, K., Yu, DH. (1997). New strategies in locally advanced breast cancer. In: Pollock, R.E. (eds) Surgical Oncology. Cancer Treatment and Research, vol 90. Springer, Boston, MA. https://doi.org/10.1007/978-1-4615-6165-1_14

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