High-dose chemotherapy with autologous hematopoietic progenitor cell support for metastatic and high-risk primary breast cancer.

High-dose chemotherapy (HDCT) is being evaluated in the treatment of metastatic and high-risk primary breast cancer. The actuarial 2-year disease-free survival rate for patients with stage IV breast cancer is approximately 15% to 20%. A single metastatic site and achievement of a complete response to induction chemotherapy may be favorable prognostic indicators for disease-free survival after HDCT. Phase II studies in patients with primary breast cancer and > or = 10 and four to nine involved axillary nodes are encouraging. Prospective randomized trials are ongoing in these patient groups. Various strategies are being investigated to reduce the incidence of relapse after HDCT.