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You are here: Home: BCU 4|2002: Program Supplement: Case 7
Miami Breast Cancer
Conference:
Tumor Board Case 7 Eleftherios Mamounas, MD
A young woman with a
tumor too large for breast conservation |
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| The patient is a 50-year-old woman
with a 4.5 cm right breast mass in the lower-outer quadrant
and a 3 cm ipsilateral axillary node. She wishes to
have breast conservation, which is not currently possible
due to her small breast size. What is your diagnostic
recommendation?
The patient had an FNA of the breast and
axilla, both of which show adenocarcinoma. What is your
treatment recommendation?
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One of the disadvantages of FNA is the difficulty of performing
adequate estrogen and progesterone receptor assays. Most of the
attendees would use AC neoadjuvant chemotherapy, which was studied
by the NSABP and found to downstage most patients without compromising
long-term outcome. Dr Mamounas off e red this patient participation
in a randomized clinical trial, protocol NSABP B-27. The patient
accepted and was randomized to AC followed by docetaxel given preoperatively.
The patient had a complete tumor response, which was documented
during breast - conserving surgery and axillary dissection. The
patient is now doing well and is free of cancer. No estrogen receptor
information is available to guide future therapy.
NSABP. The effect of primary tumor response of adding sequential
Taxotere to Adriamycin and cyclophosphamide: Preliminary results
from NSABPProtocol B-27. Breast Cancer Res Treat 2001;
Abstract
5.
Smith IC et al. Neoadjuvant chemotherapy in breast cancer:
Significantly enhanced response with docetaxel. J Clin Oncol
2002;20(6):1456-66. Abstract
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