scholarly journals Neoadjuvant Radio(chemo)therapy for Breast Cancer: An Old Concept Revisited

Breast Care ◽  
2020 ◽  
Vol 15 (2) ◽  
pp. 112-117 ◽  
Author(s):  
Christiane Matuschek ◽  
Carolin Nestle-Kraemling ◽  
Thorsten Kühn ◽  
Tanja Fehm ◽  
Edwin Bölke ◽  
...  
Keyword(s):  
Breast Cancer ◽  
High Risk ◽  
Breast Implants ◽  
Standard Of Care ◽  
Time Interval ◽  
Radiation Technology ◽  
Esophagus Carcinoma ◽  
Prospective Trials ◽  
Risk Breast Cancer

Background: The international standard of care for the treatment of high-risk breast cancer (BC) consists of neoadjuvant chemotherapy (NACT) and surgery followed by adjuvant whole breast/chest wall irradiation. In this setting, the time interval from the start of NACT to the end of radiotherapy (RT) is usually postponed to 6 months or longer. In addition to this, a high percentage of capsular fibrosis may occur when breast implants are irradiated. Most of these disadvantages could be avoided by using preoperative RT (PRT). PRT is already the standard of care in several other tumor entities (rectal cancer, esophagus carcinoma, lung cancer, and soft tissue sarcoma). Nevertheless, PRT in BC has been tested in several trials, but randomized prospective trials using modern radiation technology and systemic therapies are lacking. The available evidence summarized in this review indicates that PRT may improve survival and reduce long-term toxicity in patients with a higher risk of recurrence and should be consequently tested in a randomized trial. Summary: Prospective, randomized trials concerning PRT in high-risk BC are needed. We plan to conduct a NeoRad trial (NACT followed by PRT in high-risk BC). Key Messages: Prospective, randomized studies concerning PRT in high-risk BC are needed.

Long-term follow-up of autologous hematopoietic stem cell transplantation for stage II/III breast cancer.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 7121-7121
Author(s):  
Andrew D. Meyer ◽  
Angelica L. Tolentino ◽  
Jacob D. Bitran ◽  
Leonard M. Klein
Keyword(s):  
Breast Cancer ◽  
High Risk ◽  
High Dose Chemotherapy ◽  
High Dose ◽  
Secondary Malignancies ◽  
Study Population ◽  
High Risk Breast Cancer ◽  
High Risk Breast ◽  
Risk Breast Cancer

7121 Background: In the 1980s and 1990s, adjuvant chemotherapy with high-dose chemotherapy (HDC) and autologous stem cell transplantation (ASCT) was utilized for the treatment of high-risk breast cancer. Previous studies showed that ASCT significantly reduced the risk of relapse in these patients, but failed to provide evidence of improved overall survival when compared with standard therapy in randomized trials. Due to the mortality, morbidity, and cost associated with ASCT and lack of a clear overall survival benefit, the use of HDC with ASCT for high-risk breast cancer was halted. In this retrospective, observation study, we analyzed the toxicity and efficacy of ASCT in high-risk breast cancer at a large community hospital. Methods: The study population consisted of 57 women diagnosed with high-risk primary breast cancer who underwent treatment with HDC followed by ASCT from 1991-1999. Women receiving treatment for metastatic breast cancer were excluded. The medical records of the study population were retrospectively reviewed, with particular attention to long-term toxicities and efficacy. Results: Fifty seven patients were evaluated: 54 with ductal and/or lobular breast cancer and 3 with inflammatory breast cancer. Median age was 44 years (29- 61). Twenty six patients (46%) were alive at time of review. Twelve patients (21%) experienced a recurrence of their breast cancer. Four patients (7%) developed secondary malignancies. Two patients (4%) experienced cardiac toxicities. Estrogen/progesterone receptor-positive breast cancers accounted for 42% of recurrences, 100% of secondary malignancies, and 50% of cardiac toxicities. HER-2/neu status analysis revealed amplification in 17% of breast cancer recurrences, but in no cases of secondary malignancy or cardiac toxicity. Conclusions: High-dose chemotherapy and ASCT can be effective in reducing long-term recurrences in women with high-risk, Stage II/III breast cancer. This treatment, however, carries an associated risk of secondary malignancies and cardiac toxicities. Estrogen/progesterone receptor-positive breast cancer appears to have a greater association with disease recurrence and secondary malignancies.

Long-Term Efficiency and Toxicity of Adjuvant Dose-Dense Sequential Adriamycin-Paclitaxel-Cyclophosphamide Chemotherapy in High-Risk Breast Cancer

Oncology ◽  
2010 ◽  
Vol 78 (3-4) ◽  
pp. 271-273
Author(s):  
Gyöngyi Kelemen ◽  
Gabriella Uhercsák ◽  
Katalin Ormándi ◽  
József Eller ◽  
László Thurzó ◽  
...  
Keyword(s):  
Breast Cancer ◽  
High Risk ◽  
Dose Dense ◽  
High Risk Breast Cancer ◽  
High Risk Breast ◽  
Risk Breast Cancer

Study of Failure Pattern Among High-Risk Breast Cancer Patients With or Without Postmastectomy Radiotherapy in Addition to Adjuvant Systemic Therapy: Long-Term Results From the Danish Breast Cancer Cooperative Group DBCG 82 b and c Randomized Studies

2006 ◽  
Vol 24 (15) ◽  
pp. 2268-2275 ◽  
Author(s):  
Hanne M. Nielsen ◽  
Marie Overgaard ◽  
Cai Grau ◽  
Anni R. Jensen ◽  
Jens Overgaard
Keyword(s):  
Breast Cancer ◽  
High Risk ◽  
Cancer Patients ◽  
Disease Recurrence ◽  
Breast Cancer Patients ◽  
High Risk Breast Cancer ◽  
High Risk Breast ◽  
Risk Breast Cancer

Purpose Postmastectomy radiotherapy (RT) in high-risk breast cancer patients can reduce locoregional recurrences (LRRs) and improve disease-free and overall survival. The aim of this analysis was to examine the overall disease recurrence pattern among patients randomly assigned to receive treatment with or without RT. Patients and Methods A long-term follow-up was performed among the 3,083 patients from the Danish Breast Cancer Cooperative Group 82 b and c trials, except in those already recorded with distant metastases (DM) or contralateral breast cancer (CBC). The end points were LRR, DM, and CBC, and the follow-up continued until DM, CBC, emigration, or death. Information was selected from medical records, general practitioners, and the National Causes of Death Registry. The median potential follow-up time was 18 years. Results The 18-year probability of any first breast cancer event was 73% and 59% (P < .001) after no RT and RT, respectively (relative risk [RR], 0.68; 95% CI, 0.63 to 0.75). The 18-year probability of LRR (with or without DM) was 49% and 14% (P < .001) after no RT and RT, respectively (RR, 0.23; 95% CI, 0.19 to 0.27). The 18-year probability of DM subsequent to LRR was 35% and 6% (P < .001) after no RT and RT, respectively (RR, 0.15; 95% CI, 0.11 to 0.20), whereas the probability of any DM was 64% and 53% (P < .001) after no RT versus RT, respectively (RR, 0.78; 95% CI, 0.71 to 0.86). Conclusion Postmastectomy RT changes the disease recurrence pattern in high-risk breast cancer patients; fewer patients have LRR as first site of recurrence, and overall fewer patients have DM.

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