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document
West Midlands Oncology Association trials of adjuvant chemotherapy in operable breast cancer : results after a median follow-up of 7 years . I . Patients with involved axillary lymph nodes . The aim of this study was to test the effectiveness of a regimen of combination chemotherapy known to be active in advanced breast cancer when given as an adjuvant treatment after mastectomy . A total of 569 patients with cancer of the breast and involvement of axillary lymph nodes were randomised , after simple mastectomy with axillary sampling , to receive either no adjuvant treatment or intravenous adriamycin 50 mg , vincristine 1 mg , cyclophosphamide 250 mg , methotrexate 150 mg and fluorouracil 250 mg ( AVCMF ) every 21 days for eight cycles . Randomisation was stratified according to menopausal status and tumour size . Treatment was started within 14 days of surgery in 94 % of patients . Eighty-eight per cent of patients received at least seven cycles of chemotherapy with no dose reduction . The median relapse-free survival was prolonged by 14 months in patients treated with AVCMF ( chi2 1 = 11.7 ; P = 0.0006 ) . In the premenopausal group this period was 17 months ( chi2 1 = 8.8 ; P = 0.003 ) compared with 8 months in the post-menopausal group ( chi2 1 = 3.3 ; P = 0.07 ) . Neither overall survival nor survival in these subgroups was significantly influenced by treatment .
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Intervention_Pharmacological
adjuvant chemotherapy
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Intervention_Pharmacological
regimen of combination chemotherapy
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Intervention_Surgical
simple mastectomy with axillary sampling
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Intervention_Pharmacological
no adjuvant treatment
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Intervention_Pharmacological
intravenous adriamycin
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Intervention_Pharmacological
vincristine
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Intervention_Pharmacological
cyclophosphamide
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Intervention_Pharmacological
methotrexate
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Intervention_Pharmacological
fluorouracil
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Intervention_Pharmacological
( AVCMF )
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Intervention_Pharmacological
AVCMF
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Outcome_Mortality
median relapse-free survival
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Outcome_Mortality
overall survival nor survival
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Participant_Condition
breast cancer :
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Participant_Condition
involved axillary lymph nodes
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Participant_Sample-size
569
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Participant_Condition
cancer of the breast and involvement of axillary lymph nodes
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Participant_Condition
premenopausal
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Participant_Condition
post-menopausal