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Interruption of Menstrual Cycle by Chemotherapy Associated with Improved Survival in Early Breast Cancer
Date:6/3/2010

epartment of Human Oncology at Allegheny General Hospital.

Following primary surgery with total mastectomy or lumpectomy plus axillary nodal dissection, a total of 5,351 premenopausal and postmenopausal women with operable, lymph node-positive, early stage breast cancer were enrolled in the clinical trial and randomly assigned to receive either four cycles of doxorubicin and cyclophosphamide followed by four cycles of docetaxel (sequential ACT); four cycles of doxorubicin and docetaxel (doxorubicin-docetaxel); or four cycles of doxorubicin, cyclophosphamide and docetaxel (concurrent ACT).

At a median follow-up of 73 months, eight year overall patient survival was improved in the sequential ACT group (83%) as compared to both the doxorubicin-docetaxel group (79%) and the concurrent ACT group (79%). Eight-year disease free survival (factoring local, regional or distant breast cancer recurrence, second primary cancer or death from any cause before recurrence) was improved in the sequential ACT group (74%) compared to the doxorubicin-docetaxel group (69%) and the concurrent ACT group (69%).

“This trial showed that the sequential administration of ACT in the adjuvant treatment of operable node positive breast cancer provided a significant 17% reduction in mortality over doxorubicin-docetaxel and a clear advantage over both concurrent treatment approaches in terms of disease free survival,” Dr. Wolmark said.

In addition to Drs. Geyer and Wolmark, other AGH oncologists contributing to the study included D. Lawrence Wickerham, MD, AGH surgical oncologist and Associate Chair of the NSABP and Thomas Julian, MD, Associate Director of the AGH Breast Center and a Principal Investigator for the NSABP at AGH.

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