Document Detail

Surgical procedure after primary chemotherapy of breast carcinoma--an unresolved clinical problem
MedLine Citation:
PMID:  10857211     Owner:  NLM     Status:  MEDLINE    
Neoadjuvant chemotherapy has more and more become clinical routine during the past years. Results from large randomized trials like NSABP-B18 show that survival parameters are not affected if sequence of therapy is changed. Survival parameters have been intensively studied, but surgical standards after primary chemotherapy are much less well defined. Results from the early trials comparing lumpectomy or quadrantectomy with mastectomy are generally transposed to the neoadjuvant situation. In this context the "result of downstaging" is surgically treated like otherwise the primary tumor would have been treated. Though local recurrence rates reported after primary chemotherapy are not increased within the whole population this may not be correct for subgroups. E.g. within the NSABP-B18 trial significantly higher local recurrence rates are reported for those patients who initially were proposed to have mastectomy and who actually received lumpectomy after effective primary chemotherapy. Another unresolved problem is surgery after complete remission, which as histopathology demonstrates corresponds often not to pathological complete remission. Therefore in most cases the initially involved area is resected, which may result in a more radical surgical approach to complete remission than to partial remission. Further standardisation of surgical approach to patients after neoadjuvant chemotherapy should be evaluated within phase III trials.
U Nitz; M Rezai; A Daubel; S Mohrmann; H G Bender
Publication Detail:
Type:  English Abstract; Journal Article; Review    
Journal Detail:
Title:  Zentralblatt für Gynäkologie     Volume:  122     ISSN:  0044-4197     ISO Abbreviation:  Zentralbl Gynakol     Publication Date:  2000  
Date Detail:
Created Date:  2000-08-01     Completed Date:  2000-08-01     Revised Date:  2008-02-11    
Medline Journal Info:
Nlm Unique ID:  21820100R     Medline TA:  Zentralbl Gynakol     Country:  GERMANY    
Other Details:
Languages:  ger     Pagination:  248-54     Citation Subset:  IM    
Universitätsfrauenklinik, Düsseldorf.
Vernacular Title:
Operatives Vorgehen nach primärer Chemotherapie des Mammakarzinoms--eine unsichere klinische Situation.
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MeSH Terms
Breast Neoplasms / drug therapy*,  mortality,  surgery
Combined Modality Therapy
Neoadjuvant Therapy*
Survival Rate

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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