Single-agent epirubicin as primary chemotherapy in T2-T3, N0-N2, M0 breast carcinoma:: 6-year follow-up

Objective: Single-agent epirubicin was tested as primary chemotherapy treatment in patients with early breast cancer 13 cm. Methods: 100 women with locally advanced breast cancer 13 cm were treated with three cycles of single-agent epirubicin at a dose of 120 mg/m(2). All patients showing tumor shrinkage to less than 3 cm were considered candidates for conservative surgery (quadrantectomy); in the remaining patients modified radical mastectomy was carried out. Postsurgical treatment consisted of CMF chemotherapy except for postmenopausal node-positive, estrogen-positive patients who were assigned to hormonal treatment with tamoxifen and postmenopausal node-negative, estrogen-positive ones who did not receive any treatment. Results: Quadrantectomy was carried out in 71 patients. At the median follow-up time of 69 months, the relapse rate was 29.6% among patients who underwent quadrantectomy ( 21 out of 71) and 58.6% among patients who underwent modified radical mastectomy ( 17 out of 29). Conclusions: Single-agent chemotherapy with anthracyclines could appear to be an effective treatment in inducing a tumor downstaging in patients with early breast cancer 13 cm. This treatment can be administered outside clinical trials in patients who desire to preserve their body integrity. Further prospective, randomized trials are needed in order to validate and better define the role of epirubicin in the neoadjuvant strategy of breast cancer patients. Copyright (C) 2004 S. Karger AG, Basel.