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Second malignancies after CMF for resectable breast cancer.

P Valagussa, G Tancini, G Bonadonna

Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology

|August 1, 1987

Summary

Adjuvant chemotherapy using cyclophosphamide, methotrexate, and fluorouracil (CMF) did not increase the risk of second solid tumors in breast cancer patients. Long-term follow-up showed no significant difference in second malignancy rates compared to surgery alone.

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Area of Science:

Oncology
Clinical Trials
Cancer Research

Background:

Adjuvant chemotherapy is a standard treatment for early-stage breast cancer.
Concerns exist regarding the long-term risk of secondary malignancies following chemotherapy.

Purpose of the Study:

To evaluate the risk of second solid tumors in women with breast cancer treated with adjuvant cyclophosphamide, methotrexate, and fluorouracil (CMF).

Main Methods:

Two randomized studies included 845 women with resectable breast cancer and positive axillary nodes.
Patients underwent mastectomy; 666 received adjuvant CMF chemotherapy.
Median follow-up exceeded 10 years.

Main Results:

No cases of acute nonlymphocytic leukemia were detected.

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21 second solid tumors (excluding contralateral breast cancer) were documented.

Cumulative frequencies of second tumors were similar between surgery alone (4%) and CMF (4.2%), with no age-related differences.

Conclusions:

Current evidence does not support an increased risk of second malignancies after adjuvant CMF in this patient cohort.
Observed second tumors may be due to chance rather than solely attributable to chemotherapy.