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Radiotherapy in the Therapeutic Strategy to Breast Cancer

  • J. Stjernswärd
Part of the Recent Results in Cancer Research / Fortschritte der Krebsforschung / Progrès dans les recherches sur le cancer book series (RECENTCANCER, volume 62)

Abstract

There is a great uncertainty regarding the optimal therapeutic strategy for breast cancer, not only in regard to the traditional role of surgery and radiotherapy, but also the optimal effect of cytotoxic chemotherapy treatment designs with a minimal toxicity, the optimal adjuvant hormone therapy, and the possibility of immunotherapy. The role of radiotherapy in a combined modality approach to breast cancer needs reevaluation, trying to explore the optimal effectiveness of each treatment method: surgery, radiotherapy, chemotherapy, and hormonotherapy, perhaps also immunotherapy. Much remains to be understood about how these treatment modalities work in synergism or in antagonism with each other and their optimal timing and combination so as not to over or undertreat the patient. The old hierarchic approach of using the above treatment modalities sequentially should be forgotten and replaced by an active search and identification of high risk groups with occult widespread disease at the time of diagnosis, offering these women systemic therapies. In addition, local therapies should be combined and explored wisely so as to achieve minimal morbidity and an optimal effect of systemic therapies, allowing an identification of patients with high risk for disseminated disease. There is no doubt, however, that the search for systemic adjuvant therapies that may be curative is a sound therapeutic principle in a disease that presently is disseminated in most cases at the time of diagnosis.

Keywords

Breast Cancer Systemic Therapy Preoperative Irradiation Radical Mastectomy Operable Breast Cancer 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Amalric, R., Clement, F., Santamaría, F., Ayme, Y., Brandone, H., Clerc, S., Pollet, J. F., D’Estienne Y D’Orues, J. F., Spitalier, J. M.: Radiothérapie curvative à expérance conservatrice des cancers du sein operables. 403 cas de 5 ans. Bulletin du Cancer 63, 239–248 (1976).PubMedGoogle Scholar
  2. 2.
    Broder, L. E., Tormey, D. C.: Combination chemotherapy of carcinoma of the breast. Cancer Treatment Reviews 1, 183–203 (1974).CrossRefGoogle Scholar
  3. 3.
    Calle, R., Pilleron, J. P., Schlienger, P.: Thérapeutiques “à visée conservatrice” des épithéliomas mammaires. Bulletin du Cancer 60, 217–231 (1973).Google Scholar
  4. 4.
    Calle, R.: The role of radiation therapy in the loco-regional treatment of breast cancer. In: Breast Cancer: A Multidiscipliniary Approach, Recent Results in Cancer Research. Berlin-Heidelberg-New York: Springer-Verlag, 1976, Vol. LVII, pp. 164–175.Google Scholar
  5. 5.
    Castro, J. E.: Orchidectomy and the immune response. I. Effect of orchidectomy on lymphoid tissue of mice. Proc. R. Soc. Lond. (Biol) 185, 425–436 (1974).CrossRefGoogle Scholar
  6. 6.
    Chu, F. C., Lin, F. J., Kim, J. H., Huh, S. H., Garmatics, C. J.: Locally recurrent carcinoma of the breast. Cancer 37, 2677–2681 (1976).PubMedCrossRefGoogle Scholar
  7. 7.
    Fitzpatrick, P. J., Rider, W. D.: Half body radiotherapy. Int. J. Radiation Oncology Biol. Phys. 1, 197–207 (1976).CrossRefGoogle Scholar
  8. 8.
    Fletcher, G. H., Montague, E., Nelson, A. J.: Combination of conservative surgery and irradiation for cancer of the breast. Amer. J. Roentg. 162, 216–222 (1976).Google Scholar
  9. 9.
    Fletcher, G. H.: Reflections on breast cancer. Int. J. Radiation Oncology Biol. Phys. 1, 759–779 (1976).CrossRefGoogle Scholar
  10. 10.
    Forrest, A. P. M., Roberts, M. M., Cant, E., Shivas, A. A.: Simple mastectomy and pectoral node biopsy. Brit. J. Surg. 63, 569–575 (1976).PubMedCrossRefGoogle Scholar
  11. 11.
    Frank, C. R., Williams, Y.: Prognosis value of peripheral lymphocyte count in hormone therapy of advanced breast cancer. Brit. J. Cancer 34, 641–644 (1976).CrossRefGoogle Scholar
  12. 12.
    Holt, J. E., Lee, Y. T.: Peripheral lymphocyte counts and results of therapeutic castration for advanced mammary cancer. Ann. Surg., 175, 403–408, 1972.PubMedCrossRefGoogle Scholar
  13. 13.
    Hoge, A. F., Hartsack, J. M., Kollmorgen, G. M., Shilling, J. A.: Endrocrine and immunological studies in breast cancer. Amer. J. Surg. 126, 722–727 (1973).PubMedCrossRefGoogle Scholar
  14. 14.
    La Cour, J., Bucalossi, V., Cacers, E., Jacobelli, G., Koszarowski, T., Le, M., Rumeau-Rouquette, C., Veronesi, U.: Radical mastectomy versus radical mastectomy plus internal dissection. Five year results of an international cooperative study. Cancer 37, 206–214 (1976).CrossRefGoogle Scholar
  15. 15.
    Mathé, G.: How far are in vivo models of experimental medicine valid for human medicine. Biomedicine 24, 225–226 (1976).PubMedGoogle Scholar
  16. 16.
    Meyer, K. K.: Radiation-induced lymphocyte-immune deficiency. A factor in the increased visceral metastases and decreased hormone responsiveness of breast cancer. Arch. Surg. 101, 114–121 (1970).PubMedCrossRefGoogle Scholar
  17. 17.
    Papillon, J., Montbarbon, J. H., Ingels, J.: Le traitement conservateur du cancer du sein par l’association tumorectomie + radiation. J. Belge Radiol. (10) 55, 129–137 (1972).PubMedGoogle Scholar
  18. 18.
    Perez, C. A.: Pre-operative irradiation and the treatment of cancer. Front. Rad. Therapy Onc. 5, 1–7 (1970).Google Scholar
  19. 19.
    Pierquin, B.: Les techniques d’irradiation exclusive des cancers du sein. J. Radiol. Electrol. 56, 443–445 (1975).Google Scholar
  20. 20.
    Pierquin, B., Chassagne, D., Cox, J. D.: Toward consistent local control of certain malignant tumors. Endoradiotherapy with Iridium 192. Radiology 99, 661–667 (1971).PubMedGoogle Scholar
  21. 21.
    Radov, L. A., Haskill, J. S., Kan, J. H.: Host immune potentiation of drug responses to a murine mammary adenocarcinoma. Int. J. Cancer 17, 773–779 (1976).PubMedCrossRefGoogle Scholar
  22. 22.
    Salsbury, A. J.: The significance of circulating cancer cells. Cancer Treatment Review 2, 55–72 (1975).CrossRefGoogle Scholar
  23. 23.
    Samuel, M. L., Lanzotti, V. J., Holoye, P. Y., Boyle, L. E., Smith, T. L., Johnson, D. E.: Combination chemotherapy in germinal cell tumors. Cancer Treatment Review. Hellman, K., Carter, S. K. (eds.). 3, 185–204 (1976).CrossRefGoogle Scholar
  24. 24.
    de Schryver, A.: The Stockholm breast cancer trial: preliminary report of a randomized study concerning the value of pre-operative radiotherapy in operable disease. Int. J. Oncology Biol. Phys. 1, 601–609 (1976).CrossRefGoogle Scholar
  25. 25.
    Stjernswärd, J.: Immunological changes after radiotherapy for mammary carcinoma. Ann. Ins. Pasteur 122, 883–894 (1972).Google Scholar
  26. 26.
    Stjernswärd, J., Jondal, M., Vanky, F., Wigzell, H., Sealy, R.: Lymphopenia and change in distribution of human B and T lymphocytes in peripheral blood induced by irradiation for mammary carcinoma. Lancet (1972) I, 1352–1356.CrossRefGoogle Scholar
  27. 27.
    Stjernswärd, J.: Decreased survival correlated to local irradiation in “early” operable breast cancer. Lancet (1974) II, 1285–1286.CrossRefGoogle Scholar
  28. 28.
    Stjernswärd, J.: Radiotherapy, host immunity and cancer spread. In: Secondary Spread in Breast Cancer. News Aspects of Breast Cancer. Stoll, B. (ed.). London: Heinemann Med. Books Ltd., 1977, Vol. III, pp. 139–167.Google Scholar
  29. 29.
    Stjernswärd, J.: Adjuvant radiotherapy trials in breast cancer: a report to the profession. Washington, 1976. Cancer 39, 2846–2867 (1977).PubMedCrossRefGoogle Scholar
  30. 30.
    Stjernswärd, J.: Can survival be decreased by post-operative irradiation. In: Current Concepts in Cancer—Up Dated Breast Cancer. Int. J. of Radiation Oncology, 1977 (in press).Google Scholar
  31. 31.
    Tubiana, M., Chauvel, P., Renaud, A., Malaise, E. P.: Vitesse de croissance et histoire naturelle du cancer du sein. Bull, du Cancer 62, 341–358 (1975).Google Scholar

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© Springer-Verlag Berlin · Heidelberg 1977

Authors and Affiliations

  • J. Stjernswärd

There are no affiliations available

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