Document Detail

Conservation treatment intensified with tamoxifen and CAF chemotherapy for subareolar breast cancers.
MedLine Citation:
PMID:  9769365     Owner:  NLM     Status:  MEDLINE    
Formerly, patients with subareolar breast cancers have not been good candidates for breast-conservation treatment (BCT) in Japan. However, recently it was reported that patients with subareolar cancers were good candidates for this treatment. In order to improve both cosmetic results and survival rates, we performed BCT for 27 patients with subareolar breast cancers following pre-operative CAF chemotherapy and tamoxifen administration. From August 1989 to June 1998, we performed BCT for 200 out of 206 patients who visited our hospital with the desire of breast-conservation. Of these patients, 27 presented with tumors within 2 cm of the nipple areolar complex. For 26 of these 27 patients, breast-conserving surgery was performed following two to four times of CAF chemotherapy, and another one patient did not undertake any surgical resection. Following the surgery, patients were treated with radiation therapy to the intact breast and ipsilateral axilla to a total dose of 4,400 cGy with electron conedown to a total dose of 5,300 cGy. Their primary tumors were at T4bN0 in 1 case, T2N1b in 5 cases, T2N0 in 18 cases, and T1cN0 in 3 cases. Tamoxifen was administered to all the patients. CAF chemotherapy was performed six times for stage I patients, and eight times for stage II patients in total. For one patient with direct tumor invasion to the nipple, intraarterial infusion chemotherapy was performed following radiation therapy and CAF chemotherapy, without any surgical resection. For another 26 patients, breast-conserving surgery was performed, and 5 of them underwent lumpectomy under local anesthesia on an outpatient basis. For these 26 patients, the microscopic surgical margin was positive for 8 patients, close for 6 patients, negative for 10 patients, and unknown for 2 patients. All patients are alive with no evidence of disease after a follow-up of approximately 47 months on average, and all of their cosmetic results are estimated as excellent or good. It is concluded that BCT intensified with preoperative CAF chemotherapy and tamoxifen for subareolar breast cancers is a satisfying treatment modality in terms of both cosmetic results and survival rates.
Y Ogawa; A Nishioka; T Inomata; N Tsuboi; N Hayase; M Fukumoto; S Yoshida; N Tohchika; Y Tanaka; M Kumon
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Oncology reports     Volume:  5     ISSN:  1021-335X     ISO Abbreviation:  Oncol. Rep.     Publication Date:    1998 Nov-Dec
Date Detail:
Created Date:  1998-11-25     Completed Date:  1998-11-25     Revised Date:  2006-04-24    
Medline Journal Info:
Nlm Unique ID:  9422756     Medline TA:  Oncol Rep     Country:  GREECE    
Other Details:
Languages:  eng     Pagination:  1337-41     Citation Subset:  IM    
Department of Radiology, Kochi Medical School, Oko-cho, Nankoku-shi, Kochi-Prefecture 783-8505, Japan.
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MeSH Terms
Antineoplastic Agents, Hormonal / therapeutic use*
Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
Breast Neoplasms / drug therapy*,  mortality,  radiotherapy,  surgery
Combined Modality Therapy
Cyclophosphamide / administration & dosage
Doxorubicin / administration & dosage
Fluorouracil / administration & dosage
Mastectomy, Segmental*
Middle Aged
Retrospective Studies
Survival Rate
Tamoxifen / therapeutic use*
Reg. No./Substance:
0/Antineoplastic Agents, Hormonal; 0/CAF protocol; 10540-29-1/Tamoxifen; 23214-92-8/Doxorubicin; 50-18-0/Cyclophosphamide; 51-21-8/Fluorouracil

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