Primary medical (neoadjuvant) chemotherapy with continuous infusional 5-FU (F), epirubicin (E) and cisplatin (P) for large operable breast cancer: A very active new regimen

Abstract

mens, from 1988 to 1990 and relate them to the surgery adopted. 150 (66%) were premenopausal at diagnosis and 77 (34%) were postmenopausal; median age was 49 years. In 20 1 cases (9 1%) quadrantectomy + axillary dissection + radiotherapy was carried out. In 26 cases (9%) tumour size did not decrease or increased, and mastectomy was performed. In 8 cases (3.5%) no tumour was found on microscopic examination, while in 158 (70%) the macroscopic size of the tumour had reduced to 12.5 cm. Axillary lymphnodes were free of metastases in 90 patients (38.8%). It is concluded that primary chemotherapy can expand the indication for breast conservation to tumours of 3 cm or more in diameter. Careful attention should be paid however, to a number of aspects of surgical technique: the tumour should be precisely located with tattoo marks on the skin prior to chemotherapy; the extent of tumour regression must be carefully evaluated: the presence of microcalcifications must always be taken into account and the incision must respect radicality and aesthetic criteria. The specimen must be evaluated microscopically and the margins determined. Finally, adequate attention must be paid to breast re-modelling.