Preoperative chemotherapy: updates of National Surgical Adjuvant Breast and Bowel Project Protocols B-18 and B-27.

@article{Rastogi2008PreoperativeCU,
  title={Preoperative chemotherapy: updates of National Surgical Adjuvant Breast and Bowel Project Protocols B-18 and B-27.},
  author={Priya Rastogi and Stewart J. Anderson and Harry D. Bear and Charles E. Geyer and Morton S. Kahlenberg and André Robidoux and Richard G. Margolese and James L. Hoehn and Victor G Vogel and Shaker R. Dakhil and Deimante Tamkus and Karen M. King and Eduardo R. Pajon and Mary Johanna Wright and Jean Robert and Soonmyung Paik and Eleftherios P Mamounas and Norman Wolmark},
  journal={Journal of clinical oncology : official journal of the American Society of Clinical Oncology},
  year={2008},
  volume={26 5},
  pages={
          778-85
        }
}
  • P. RastogiS. Anderson N. Wolmark
  • Published 10 February 2008
  • Medicine
  • Journal of clinical oncology : official journal of the American Society of Clinical Oncology
PURPOSE National Surgical Adjuvant Breast and Bowel Project (NSABP) Protocol B-18 was designed to determine whether four cycles of doxorubicin and cyclophosphamide (AC) administered preoperatively improved breast cancer disease-free survival (DFS) and overall survival (OS) compared with AC administered postoperatively. Protocol B-27 was designed to determine the effect of adding docetaxel (T) to preoperative AC on tumor response rates, DFS, and OS. PATIENTS AND METHODS Analyses were limited… 

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References

SHOWING 1-10 OF 40 REFERENCES

Sequential preoperative or postoperative docetaxel added to preoperative doxorubicin plus cyclophosphamide for operable breast cancer:National Surgical Adjuvant Breast and Bowel Project Protocol B-27.

  • H. BearS. Anderson N. Wolmark
  • Medicine
    Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • 2006
The addition of preoperative or postoperative T after preoperative AC did not significantly affect OS, slightly improved DFS, and decreased the incidence of local recurrences.

Preoperative chemotherapy in patients with operable breast cancer: nine-year results from National Surgical Adjuvant Breast and Bowel Project B-18.

Marginally statistically significant treatment-by-age interactions appear to be emerging for survival and DFS, suggesting that younger patients may benefit from preoperative therapy, whereas the reverse may be true for older patients.

Effect of preoperative chemotherapy on local-regional disease in women with operable breast cancer: findings from National Surgical Adjuvant Breast and Bowel Project B-18.

  • B. FisherA. Brown N. Dimitrov
  • Medicine
    Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • 1997
Preoperative therapy reduced the size of most breast tumors and decreased the incidence of positive nodes in women with primary breast cancer and should be considered for the initial management of breast tumors judged too large for lumpectomy.

The effect on tumor response of adding sequential preoperative docetaxel to preoperative doxorubicin and cyclophosphamide: preliminary results from National Surgical Adjuvant Breast and Bowel Project Protocol B-27.

  • H. BearS. Anderson N. Wolmark
  • Medicine
    Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • 2003
The addition of four cycles of preoperative docetaxel after four cyclesof preoperative AC significantly increased clinical and pathologic response rates for operable breast cancer.

Effect of preoperative chemotherapy on the outcome of women with operable breast cancer.

  • B. FisherJ. Bryant H. Bear
  • Medicine
    Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • 1998
Preoperative chemotherapy is as effective as postoperative chemotherapy, permits more lumpectomies, is appropriate for the treatment of certain patients with stages I and II disease, and can be used to study breast cancer biology.

Effects of primary chemotherapy in conservative treatment of breast cancer patients with operable tumors larger than 3 cm. Results of a randomized trial in a single centre.

After a median follow-up of 34 months, isolated local recurrences were more frequent in the group with initial chemotherapy, which, however, experienced a better overall survival (p = 0.04).

Primary chemotherapy in operable breast cancer: eight-year experience at the Milan Cancer Institute.

Findings indicate that primary chemotherapy can be safely administered in women with large tumors and can allow breast-sparing surgery in a high fraction of patients and to assess effectively the worthiness of this approach on long-term results, properly conceived large randomized studies with newer and more effective drug regimens are warranted.

Combination chemotherapy with mastectomy or radiotherapy for stage III breast carcinoma: a Cancer and Leukemia Group B study.

This study demonstrates that prolonged control of stage III breast carcinoma can be achieved with combined modality therapy in which cytotoxic chemotherapy precedes and follows treatment directly primarily at the breast tumor, using either surgery or RT.

Multimodal treatment for locally advanced breast cancer. Result of chemotherapy-radiotherapy versus chemotherapy-surgery.

The results of present study failed to indicate that surgery per se improved the overall results including local control, over radiotherapy in a combined modality setting.

Primary chemotherapy in breast cancer: correlation between tumor response and patient outcome.

This study focused on the correlation between tumor response and patient outcome in 329 breast cancers treated with primary chemotherapy. There were 141 stage IIIB tumors, including 109 inflammatory