alexa Treatment of axillary lymph node-negative, estrogen receptor-negative breast cancer: updated findings from National Surgical Adjuvant Breast and Bowel Project clinical trials.
Microbiology

Microbiology

Journal of Microbial & Biochemical Technology

Author(s): Fisher B, Jeong JH, Anderson S, Wolmark N

Abstract Share this page

Abstract BACKGROUND: Results from three National Surgical Adjuvant Breast and Bowel Project sequentially conducted randomized trials of postoperative chemotherapy in women with estrogen receptor-negative tumors and negative axillary lymph nodes have demonstrated that a combination of methotrexate and 5-fluorouracil (MF) is more effective than surgery alone, that cyclophosphamide with MF (CMF) is more effective than MF, and that CMF and doxorubicin (Adriamycin) with cyclophosphamide (AC) are equally beneficial. This report presents updated findings from those trials, relates the results to age and menopausal status, and estimates the extent of progress made in treating such patients. METHODS: Patients were randomly assigned as follows: in B-13, 760 patients were assigned to surgery only or to MF; in B-19, 1095 patients were assigned to MF or CMF; in B-23, 2008 patients were assigned to CMF or AC. Recurrence-free survival (RFS) and overall survival (OS) were estimated according to age and menopausal status. Smoothed recurrence rates were used to evaluate patterns of recurrence as a continuous function of age. The Cox proportional hazards model was used to test for interactions between treatment and covariates and to estimate hazard ratios (HRs) for pairwise group comparisons. RESULTS: In B-13, through 16 years of follow-up, an overall benefit was seen with MF relative to surgery alone (RFS: HR = 0.59, 95\% confidence interval [CI] = 0.44 to 0.78, P<0.001; OS: HR = 0.75, 95\% CI = 0.58 to 0.98, P = 0.03). In B-19, through 13 years of follow-up, an overall benefit was seen for CMF relative to MF (RFS: HR = 0.59, 95\% CI = 0.45 to 0.77, P<0.001; OS: HR = 0.71; 95\% CI = 0.55 to 0.92; P = 0.01). In both trials, all age and menopausal groups demonstrated an RFS benefit, and most demonstrated an OS benefit. In B-23, through 8 years of follow-up, there were no statistically significant differences between the CMF and AC groups (RFS: HR = 1.00, 95\% CI = 0.79 to 1.27, P = 0.97; OS, HR = 0.92, 95\% CI = 0.73 to 1.17; P = 0.51). When women in the CMF or AC groups (B-19, B-23) were compared with those who were in the surgery-alone group (B-13), through 8 years of follow-up there was a 58\% reduction in recurrence and a 40\% reduction in mortality as a result of the chemotherapy. CONCLUSIONS: Outcomes in CMF- or AC-treated women with estrogen receptor-negative tumors and negative axillary lymph nodes were similar in all age groups. The decreased benefit from chemotherapy observed with increasing age was a result of a better outcome associated with advancing age in women who underwent surgery alone rather than a poorer outcome resulting from the use of chemotherapy. This article was published in J Natl Cancer Inst and referenced in Journal of Microbial & Biochemical Technology

Relevant Expert PPTs

Relevant Speaker PPTs

Recommended Conferences

Relevant Topics

Peer Reviewed Journals
 
Make the best use of Scientific Research and information from our 700 + peer reviewed, Open Access Journals
International Conferences 2017-18
 
Meet Inspiring Speakers and Experts at our 3000+ Global Annual Meetings

Contact Us

Agri, Food, Aqua and Veterinary Science Journals

Dr. Krish

[email protected]

1-702-714-7001 Extn: 9040

Clinical and Biochemistry Journals

Datta A

[email protected]

1-702-714-7001Extn: 9037

Business & Management Journals

Ronald

[email protected]

1-702-714-7001Extn: 9042

Chemical Engineering and Chemistry Journals

Gabriel Shaw

[email protected]

1-702-714-7001 Extn: 9040

Earth & Environmental Sciences

Katie Wilson

[email protected]

1-702-714-7001Extn: 9042

Engineering Journals

James Franklin

[email protected]

1-702-714-7001Extn: 9042

General Science and Health care Journals

Andrea Jason

[email protected]

1-702-714-7001Extn: 9043

Genetics and Molecular Biology Journals

Anna Melissa

[email protected]

1-702-714-7001 Extn: 9006

Immunology & Microbiology Journals

David Gorantl

[email protected]

1-702-714-7001Extn: 9014

Informatics Journals

Stephanie Skinner

[email protected]

1-702-714-7001Extn: 9039

Material Sciences Journals

Rachle Green

[email protected]

1-702-714-7001Extn: 9039

Mathematics and Physics Journals

Jim Willison

[email protected]

1-702-714-7001 Extn: 9042

Medical Journals

Nimmi Anna

[email protected]

1-702-714-7001 Extn: 9038

Neuroscience & Psychology Journals

Nathan T

[email protected]

1-702-714-7001Extn: 9041

Pharmaceutical Sciences Journals

John Behannon

[email protected]

1-702-714-7001Extn: 9007

Social & Political Science Journals

Steve Harry

[email protected]

1-702-714-7001 Extn: 9042

 
© 2008-2017 OMICS International - Open Access Publisher. Best viewed in Mozilla Firefox | Google Chrome | Above IE 7.0 version
adwords