Adjuvant Therapy of Premenopausal and Menopausal High-Risk Breast Cancer Patients: Present status of the Danish Breast Cancer Cooperative Group Trials 77-B and 82-B

Authors

  • P. Dombernowsky From the Departments of Oncology, Copenhagen University Hospital, Herlev, Odense University Hospital, Odense, Aarhus University Hospital, Aarhus, and Aalborg Hospital, Aalborg, the Department of Oncology Ona, the Finsen Institute, Rigshospitalet, Copenhagen, the Department of Internal Medicine F, Hillerød Hospital, Hillerød, the Department of Surgery, Vejle Hospital, Vejle, the Department of Pathology, Odense University Hospital, Odense, and the Danish Breast Cancer Cooperative Group Secretariate, the Finsen Institute, Rigshospitalet, Copenhagen, Denmark
  • H. Brincker From the Departments of Oncology, Copenhagen University Hospital, Herlev, Odense University Hospital, Odense, Aarhus University Hospital, Aarhus, and Aalborg Hospital, Aalborg, the Department of Oncology Ona, the Finsen Institute, Rigshospitalet, Copenhagen, the Department of Internal Medicine F, Hillerød Hospital, Hillerød, the Department of Surgery, Vejle Hospital, Vejle, the Department of Pathology, Odense University Hospital, Odense, and the Danish Breast Cancer Cooperative Group Secretariate, the Finsen Institute, Rigshospitalet, Copenhagen, Denmark
  • M. Hansen From the Departments of Oncology, Copenhagen University Hospital, Herlev, Odense University Hospital, Odense, Aarhus University Hospital, Aarhus, and Aalborg Hospital, Aalborg, the Department of Oncology Ona, the Finsen Institute, Rigshospitalet, Copenhagen, the Department of Internal Medicine F, Hillerød Hospital, Hillerød, the Department of Surgery, Vejle Hospital, Vejle, the Department of Pathology, Odense University Hospital, Odense, and the Danish Breast Cancer Cooperative Group Secretariate, the Finsen Institute, Rigshospitalet, Copenhagen, Denmark
  • H. T. Mouridsen From the Departments of Oncology, Copenhagen University Hospital, Herlev, Odense University Hospital, Odense, Aarhus University Hospital, Aarhus, and Aalborg Hospital, Aalborg, the Department of Oncology Ona, the Finsen Institute, Rigshospitalet, Copenhagen, the Department of Internal Medicine F, Hillerød Hospital, Hillerød, the Department of Surgery, Vejle Hospital, Vejle, the Department of Pathology, Odense University Hospital, Odense, and the Danish Breast Cancer Cooperative Group Secretariate, the Finsen Institute, Rigshospitalet, Copenhagen, Denmark
  • M. Overgaard From the Departments of Oncology, Copenhagen University Hospital, Herlev, Odense University Hospital, Odense, Aarhus University Hospital, Aarhus, and Aalborg Hospital, Aalborg, the Department of Oncology Ona, the Finsen Institute, Rigshospitalet, Copenhagen, the Department of Internal Medicine F, Hillerød Hospital, Hillerød, the Department of Surgery, Vejle Hospital, Vejle, the Department of Pathology, Odense University Hospital, Odense, and the Danish Breast Cancer Cooperative Group Secretariate, the Finsen Institute, Rigshospitalet, Copenhagen, Denmark
  • J. Panduro From the Departments of Oncology, Copenhagen University Hospital, Herlev, Odense University Hospital, Odense, Aarhus University Hospital, Aarhus, and Aalborg Hospital, Aalborg, the Department of Oncology Ona, the Finsen Institute, Rigshospitalet, Copenhagen, the Department of Internal Medicine F, Hillerød Hospital, Hillerød, the Department of Surgery, Vejle Hospital, Vejle, the Department of Pathology, Odense University Hospital, Odense, and the Danish Breast Cancer Cooperative Group Secretariate, the Finsen Institute, Rigshospitalet, Copenhagen, Denmark
  • C. Rose From the Departments of Oncology, Copenhagen University Hospital, Herlev, Odense University Hospital, Odense, Aarhus University Hospital, Aarhus, and Aalborg Hospital, Aalborg, the Department of Oncology Ona, the Finsen Institute, Rigshospitalet, Copenhagen, the Department of Internal Medicine F, Hillerød Hospital, Hillerød, the Department of Surgery, Vejle Hospital, Vejle, the Department of Pathology, Odense University Hospital, Odense, and the Danish Breast Cancer Cooperative Group Secretariate, the Finsen Institute, Rigshospitalet, Copenhagen, Denmark
  • C. K. Axelsson From the Departments of Oncology, Copenhagen University Hospital, Herlev, Odense University Hospital, Odense, Aarhus University Hospital, Aarhus, and Aalborg Hospital, Aalborg, the Department of Oncology Ona, the Finsen Institute, Rigshospitalet, Copenhagen, the Department of Internal Medicine F, Hillerød Hospital, Hillerød, the Department of Surgery, Vejle Hospital, Vejle, the Department of Pathology, Odense University Hospital, Odense, and the Danish Breast Cancer Cooperative Group Secretariate, the Finsen Institute, Rigshospitalet, Copenhagen, Denmark
  • J. Andersen From the Departments of Oncology, Copenhagen University Hospital, Herlev, Odense University Hospital, Odense, Aarhus University Hospital, Aarhus, and Aalborg Hospital, Aalborg, the Department of Oncology Ona, the Finsen Institute, Rigshospitalet, Copenhagen, the Department of Internal Medicine F, Hillerød Hospital, Hillerød, the Department of Surgery, Vejle Hospital, Vejle, the Department of Pathology, Odense University Hospital, Odense, and the Danish Breast Cancer Cooperative Group Secretariate, the Finsen Institute, Rigshospitalet, Copenhagen, Denmark
  • K. W. Andersen From the Departments of Oncology, Copenhagen University Hospital, Herlev, Odense University Hospital, Odense, Aarhus University Hospital, Aarhus, and Aalborg Hospital, Aalborg, the Department of Oncology Ona, the Finsen Institute, Rigshospitalet, Copenhagen, the Department of Internal Medicine F, Hillerød Hospital, Hillerød, the Department of Surgery, Vejle Hospital, Vejle, the Department of Pathology, Odense University Hospital, Odense, and the Danish Breast Cancer Cooperative Group Secretariate, the Finsen Institute, Rigshospitalet, Copenhagen, Denmark

DOI:

https://doi.org/10.3109/02841868809091771

Keywords:

Breast cancer, operable, high risk, adjuvant therapy, cytotoxic drugs, tamoxifen

Abstract

Abstract

From September 1977 to November 1987 high-risk (i.e. with positive axillary lymph nodes, or tumor size >5 cm or skin/fascia invasion) premenopausal and menopausal breast cancer patients have been included in 2 randomized trials. In both trials the primary surgical treatment was total mastectomy with axillary sampling. In the first trial (DBCG 77-B) 1034 patients all received postoperative radiotherapy (RT) and were further randomized to 1) no systemic treatment (0), 2) cyclophosphamide (C), or 3) cyclophosphamide + methotrexate + 5-fluorouracil (CMF). The chemotherapy was given for 1 year. With a median observation time of 7 years the actuarial survival after 9 years is 50, 60 and 65% respectively. Retrospectively, the survival benefit was observed to be most pronounced in patients with tumor size ±5 cm and with ±3 positive lymph nodes. In the subsequent study initiated in 1982 (82-B) all patients received CMF for 9 months. Furthermore they were randomized to 1) RT, 2) no further treatment, or 3) tamoxifen (TAM) for 1 year. As of November 1, 1987, 1308 patients have been included. At 4 years and with a median observation time of 2 years the survival is similar in the 3 groups. In conclusion, in high-risk premenopausal and menopausal patients adjuvant chemotherapy combined with RT resulted in a 20–30% relative reduction in mortality at 9 years compared with RT alone. Preliminary analysis of adjuvant CMF + RT, compared with CMF alone or with CMF + TAM, shows after a median observation time of more than 2 years no significant survival differences.

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Published

1988-01-01

How to Cite

Dombernowsky, P., Brincker, H., Hansen, M., Mouridsen, H. T., Overgaard, M., Panduro, J., … Andersen, K. W. (1988). Adjuvant Therapy of Premenopausal and Menopausal High-Risk Breast Cancer Patients: Present status of the Danish Breast Cancer Cooperative Group Trials 77-B and 82-B. Acta Oncologica, 27(6), 691–697. https://doi.org/10.3109/02841868809091771

Issue

Vol. 27 No. 6 (1988): Acta Oncologica

Section

Articles