LOCALLY ADVANCED NONMETASTATIC BREAST-CANCER - ANALYSIS OF PROGNOSTICFACTORS IN 125 PATIENTS HOMOGENEOUSLY TREATED WITH A COMBINED-MODALITY APPROACH

125 stage III breast cancer patients, including 51 cases of inflammato ry carcinoma, were treated with the following combined modality approa ch: three courses of primary 5-fluorouracil, doxorubicin, cyclophospha mide (FAC) chemotherapy followed by locoregional treatment and subsequ ent adjuvant chemotherapy consisting of three courses of FAC alternati ng with three courses of cyclophosphamide, methotrexate, 5-fluorouraci l (CMF). Clinical response to primary FAC was 65% (complete 10%). Resi dual tumour mass in the mastectomy specimen was >1 and less than or eq ual to 1 cm in 82 and 18% of cases, respectively. Complete pathologica l response following primary chemotherapy was achieved in only 3.5% of cases. After primary FAC and local treatment, 97% of patients were di sease-free. Overall survival (S) and progression-free survival (PFS) a t 5 years were 56 and 34%, respectively. Univariate analysis showed th at age, receptor status and clinical and pathological response to prim ary chemotherapy did not appear to influence treatment outcome signifi cantly, whereas stage, presence of inflammatory disease and number of involved nodes had a significant impact on both S and PFS.