Abstract

The forty-one female patients of breast cancer were treated with adjuvant chemotherapy following radical mastectomy were retrospectively analyaed with compared to aixty patienr.s treated with postoperative radiotherapy. The chemotherapy consisted of 12 monthly cycles of cyclophosphamide, methotrexate and 5-fluorouracil. After 45 months of study, the comparative relapse-free survival rate at three years waa significantly higher in chemotherapy group(chemotherapy group 78.0%, radiocherapy group 41. 1%: P(0.01). At three years 92.3% of patients given chemotherapy and 72, 5% of radio- therapy group remained alive. This difference was not significant. The patients with four or more positive axillary nodes had a higher per cent of relapses than those with fewer nodes. Three-year relapse-free suvival rate of chemotherapy group was aignificantly improved compared to radiotherapy group irrespective of the number of the axillary lymph nodes affected. The three-year relapse-free survival rates in hoth premenopausal women(chemotherapy group 76.5%, radiotherapy group 46.3%) and postmenopausal group(chemotherapy group 73.3%, radiotherapy group 42.0%) were increased in chemotherapy group than radiotherapy group, but statistically significant difference couldn't obtain in postmenopausal women. Five of 41 patients(12. 2i.) in chemotherapy group and 23 of 60 Patients(38.3%) in radio- therapy group had experienced reeurrence. The sites of the initial recurrence of all six patients in chemotherapy group were local-regional area, while 21 of 23 patients in radiothe- rapy group had distant metastases. These results showed postoperative adjuvant radiotherapy alone couldn't prevent distant metastasis at all. The side effects and hematologic toxicities attributable to chemotherapy were moderate and acceptable. Above short-term follow up result represented the encouragement for postoperative adju- vant chemotherapy in female breast cancer, but this study would continue to prove a real decrease rather than postoponement of relapse.