Health & Medical Cancer & Oncology

1999 Was Mixed Bag of News for Breast Cancer

1999 Was Mixed Bag of News for Breast Cancer

1999 Was Mixed Bag of News for Breast Cancer

Dec. 28, 1999 (New York) -- The news about breast cancer this year was a mixed bag at best, with researchers at one meeting early in the year casting doubt on the ability of high-dose chemotherapy and bone marrow transplantation (BMT) to improve survival for high-risk women. However, researchers at another meeting reported excellent survival after either lumpectomy (surgical removal of only the tumor) or mastectomy (surgical removal of the entire breast) among most women with a common breast disease known as ductal carcinoma in situ (DCIS).

In early spring, it was announced that the results of four of five trials set to be released at the annual meeting of the American Society of Clinical Oncology showed that women given high-dose chemotherapy and BMT had survival rates equivalent to women given more conventionally low-dose or intermediate-dose chemotherapy regimens.

Three of the five studies examined the use of high-dose chemotherapy in very high-risk breast cancer that has spread to 10 or more lymph nodes, and two investigated its role in the treatment of metastatic breast cancer (cancer that had spread to other parts of the body).

The Cancer and Leukemia Group B (CALGB) trial found no statistically significant difference in event-free survival or overall survival at 36 months among very high-risk women given high-dose chemotherapy. Likewise, the Scandinavian Breast Cancer Study Group 9401 found no statistically significant difference in recurrence rates or overall survival at 24 months but did find significantly more serious toxic effects of chemotherapy in the high-dose group.

Among those with metastatic breast cancer, the Eastern Cooperative Oncology Group reported three-year survival rates of 32% for women receiving high-dose chemotherapy/BMT and 38% for women on the lower-dose chemotherapy. In the French Randomized Protocol, PEGASE 04, there was an initial trend toward longer time to relapse of cancer among the high-dose chemotherapy/BMT group compared with standard chemotherapy group, but after five years, there was no significant difference in the relapse rate of cancer or overall survival.

The only study that showed a slight advantage of high-dose chemotherapy/BMT came from a South African team lead by Werner Bezwoda, MD, PhD, of the University of Witwatersrand Medical School in Johannesburg. Bezwoda reported five-year results showing relapse rates of 25% in the high-dose chemotherapy group and 66% in the standard-dose group. Death rates were 17% in the high-dose group and 35% in the standard-dose group.

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