Online Management of Breast Diseases Patient Education |  Physician Guidelines |  Treatment Index
News |  TransMed |  E-Mail |  Disclaimer

STAGE IIB - Breast Carcinoma

 
 
STAGE I I B - BREAST CARCINOMA
THERAPEUTIC OPTIONS
BREAST CARCINOMA STAGE II B
TMN Classification
T2N1M0
T3N0M0
Cell Type All
Description
Tumor Size Greater than 2 cm
Lymph Node Metastasis or not
No Distant Metastasis

 

Surgical Therapeutic Option 1: Lumpectomy-Axillary Dissection & Radiation - Lumpectomy-Sentinel Lymphadenectomy & Radiation (45Gy & Electron Boost)
Reference Studies: Fisher B. et al: NSABP:N Engl J Med 320-822, 1989 - Veronesi, U et Al: NCI: Eur J Cancer, 26:668,1990 - Sarrazin et al: IGR: Radiothe. Oncol, 14:177, 1989 - Birchert-Toft, M et al: DBCG: Acta Onc, 27:671, 1988 - Early Breast Cancer Trialist's Collaborative Group: Effect of radiotherapey and surgery in early breast cancer: N Engl J Med 1995;333:1444-55 - Jacobson, J. A et al: Ten year results of a comparison of conservation with mastectomy in the treatment of stage I and II breast cancer. N Engl J Med, 332-907, 1995
Contrindications: Multicentric Carcinoma
Absolute Must Lumpectomy should be obtained with clear margins status
Average Survival 75 % at 10 years
Disease Free Survival 72 % at 10 years
Therapeutic Comparison Identical Results obtained with Modified Radical Mastectomy
Hospital Stay - Surgery Average: Outpatient
Surgical Statistics
One or two stage - Lumpectomy: Clear margins needed
Axillary Dissection: 10 lymph. nodes minimum preferably
Timing of Radiation Average: 4 weeks after last surgical intervention
Radiation Statistics
Delivery: 45 to 50Gy with Electron Boost
Site of Delivery: Whole Breast
Duration and Timing of Delivery: 5 days a week for 6 weeks
Side Effects: See Radiotherapy for Breast Cancer
Post-operative Protocol -For mammographic malignant lesion: Intra-operative comparison mammogram

-6 months routine post-operative mammogram

 
Surgical Therapeutic Option 2: Modified Radical Mastectomy or Total Mastectomy with Sentinel Lymphadenectomy
Reference Studies: Fisher B. et al: NSABP:N Engl J Med 320-822, 1989 - Veronesi, U et Al: NCI: Eur J Cancer, 26:668,1990 - Sarrazin et al: IGR: Radiothe. Oncol, 14:177, 1989 - Birchert-Toft, M et al: DBCG: Acta Onc, 27:671, 1988 - Early Breast Cancer Trialist's Collaborative Group: Effect of radiotherapey and surgery in early breast cancer: N Engl J Med 1995;333:1444-55 - Jacobson, J. A et al: Ten year results of a comparison of conservation with mastectomy in the treatment of stage I and II breast cancer. N Engl J Med, 332-907, 1995
Contrindications: None
Absolute Indication Multicentric Carcinoma
Average Survival 77 % at 10 years
Disease Free Survival 69 % at 10 years
Therapeutic Comparison Identical Results obtained with Lumpectomy, Axillary Dissection & Radiation
Hospital Stay Average: Outpatient
Surgical Statistics
Axillary Dissection: 10 lymph. nodes minimum preferably

 

   
RECOMMENDATION FOR STAGE IIB

LYMPH NODES NEGATIVE or POSITIVE - ER/PR POSITIVE

TMN Classification T2N0M0 or T3N0M0
Description Tumor Size Greater than 2 cm

Lymph Nodes with of without Disease

No Evidence of Distant Spread

Recommendation CHEMOTHERAPY & HORMONAL THERAPY RECOMMENDED
RECOMMENDED CHEMOTHERAPEUTIC PROTOCOLS
CLICK ON EACH PROTOCOL
FOR DETAILED INFORMATION
ADRIAMYCIN

CYTOXAN

& TAMOXIFEN

aka: AC-T

CYTOXAN

METHOTREXATE

5FU

& TAMOXIFEN

aka: CMF-T

ORAL CYTOXAN

METHOTREXATE

5FU

& TAMOXIFEN

aka: Classic CMF-T

5FU

ADRIAMYCIN

CYTOXAN

& TAMOXIFEN

aka: FAC-T

  • PATIENTS WITH STAGE IIA LYMPH NODE POSITIVE DISEASE BUT WITH ER/PR NEGATIVE TUMORS ARE TREATED WITH CHEMOTHERAPY BUT DO NOT RECEIVE TAMOXIFEN
  • PATIENTS WITH ANY STAGE II DISEASE WITH 4-10 INVOLVED LYMPH NODES MAY BE ELIGIBLE FOR RESEARCH STUDIES
  • PATIENTS WITH ANY STAGE II DISEASE WITH GREATER THAN 10 LYMPH NODES INVOLVED MAY BE ELIGIBLE FOR RESEARCH STUDIES INCLUDING AUTOLOGOUS STEM CELL TRANSPLANTATION
 

Copyright 1997 - TransMed Network