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Salamanca University Hospital experience in the adjuvant systemic treatment of loco-regional breast cancer. Results of a medical assistance protocol of a seven-year follow-up study

Abstract:

Purpose: To evaluate the effectiveness of the adjuvant systemic therapy of breast cancer in terms of disease-free survival (DFS), overall survival (OS) and toxicity. Material and methods: We made a prospective study in a cohort of 308 patients. We designed four different escalating schedule treatments in relation to risk groups, prognostic factors and biologic factors. We used tamoxifen or anthracycline alone, or tamoxifen combined with anthracycline at two different doses. Results: The median following up was seven years. The findings for DFS ± s.d. and OS ± s.d. were as follows: node-negative patients, 86 ± 2% and 91 ± 2%, and node-positive patients, 64 ± 3% and 82 ± 3%, respectively. For the overall group, the results were 75 ± 2% DFS and 87 ± 1% OS. The main toxicity was hernatological in patients receiving chemotherapy. Conclusions: The escalating schedule treatment adjusted to patients in relation to risk group and prognostic factors optimizes the selection of chemotherapy agents and dose-intensity schedule, avoiding unnecessary toxicities and obtaining a high effectiveness in terms of DFS.