Two years of high-dose cyclophosphamide and 5-fluorouracil followed by surgery after 3 months for acute inflammatory breast carcinomas. A phase II study of 25 cases with a median follow-up of 35 months.

Twenty-five consecutive cases of inflammatory breast carcinoma were treated with high-dose cyclophosphamide and 5-fluorouracil in 5-day courses every 3 weeks for 2 years, with total mastectomy performed after the third course. The toxicity was high but acceptable in 24 of the patients, provided the doses were decreased. Tumor was found at surgery in all 24 patients, and the lymph nodes were involved in 19 of 24 cases. The median follow-up was 35 months (range, 16-76 months). Thirteen relapses were observed, three of which were exclusively locoregional. The median disease-free survival was 46 months. The expected median survival is greater than 6 years. Six patients were treated with radiotherapy for regional recurrences. The good results obtained with this severe form of the disease confirm: that chemotherapy is highly effective in primary tumors and that initial radiotherapy is not necessary in the management of this disease.