Is chemotherapy effective in reducing the local failure rate in patients with operable breast cancer?

Article Abstract:

A small percentage of breast cancer patients develop recurrent cancer even after a successful mastectomy. Radiation therapy has been used to try to reduce the rate of recurrence, but although the short-term rate is reduced, the survival rate at ten years is the same with or without radiation. Furthermore, beyond ten years, the survival rate with radiation is actually worse than without. To assess the potential usefulness of chemotherapy in preventing local recurrence of cancer after mastectomy, 768 patients were evaluated; after surgery they were treated with fluorouracil, doxorubicin, and cyclophosphamide. Of the 768, 429 patients also received radiotherapy after surgery and before chemotherapy. A group of 178 previous patients who had received only radiotherapy after mastectomy served as historical controls. Over a ten-year period, 12 percent of the patients treated with only chemotherapy experienced local recurrence, whereas 10 percent of the historical controls had recurring tumors. Patients treated with both chemotherapy and radiotherapy, however, had a 5 percent rate of recurrence, which was significantly lower than the rate in the chemotherapy-only group. Radiotherapy remains an important part of postoperative treatment for some breast cancer patients; the potential for delayed increases in risk of recurrence indicate that it should be used only in patients at higher risk, such as those with more than four lymph nodes involved at the time of surgery. Chemotherapy alone might be used for the remainder, with radiotherapy remaining a possibility for treating subsequent local recurrences. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Cancer, Radiotherapy, Chemotherapy, Mastectomy, Adjuvant chemotherapy

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Angiosarcoma arising in an irradiated breast: a case report and review of the literature

Article Abstract:

Angiosarcoma is a tumor of fibrous tissue which surrounds blood vessels. Angiosarcoma of the breast is rare, with only 159 cases ever reported. This study describes an angiosarcoma that was diagnosed in a 50-year-old woman who had radiation therapy 10 years earlier for cancer of the breast which had been treated with conservative surgery. Only one other angiosarcoma has been reported after radiation therapy of the breast. Angiosarcoma has been known to develop in the chest wall following postmastectomy irradiation. Mammography detected the angiosarcomas after skin thickening became evident in the previously irradiated breast. The tumor was removed surgically. Prognosis is dependent on early diagnosis and size of the tumor. After surgery the patient was placed on chemotherapy. There was no evidence of cancer spread. It is not known whether radiation treatments of the breast can cause angiosarcomas of the breast. Any skin thickening or breast swelling after radiation therapy has resolved should be investigated. (Consumer Summary produced by Reliance Medical Information, Inc.)

Case studies, Tumors, Radiation-induced, Radiation carcinogenesis, Angiosarcoma

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Primary malignant tumors of the trachea: a radiologic and clinical study

Article Abstract:

Tracheal tumors are rare. In adults, over half of the tumors arising in the trachea are found to be malignant. A retrospective study was carried out on 54 cases of cancer of the trachea, seen between 1949 and 1988. The most common form of tracheal cancer was found to be squamous cell carcinoma, representing 54.5 percent of the observed tumors. Adenoid cystic carcinoma followed at 18 percent; 9 percent of the tumors were observed to be adenocarcinomas. Four cases appeared to be thyroid cancer at initial presentation, and only further examination revealed that they were tracheal cancers invading the thyroid. Of the 54 cases, 15 involved multiple malignancies. Clinicians should be aware of the likelihood of multiple cancers in patients with tracheal cancer. Instead of only looking for second malignancies, they should maintain constant vigilance for second tumors during treatment. (Consumer Summary produced by Reliance Medical Information, Inc.)

Statistics, Thoracic cancer

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