CA: A Cancer Journal for Clinicians, Vol 21, 306-316, Copyright
© 1971 by American Cancer Society
Combined Approach to the Management of Incurable Breast Cancer. Part Two: Systemic Therapy and Radiotherapy
Nylene E. Eckles Ph.D., M.D.1 and
Lillian M. Fuller M.D.2
1 Associated Internist, Department of Medicine and Chief, Medical Breast Service, M. D. Anderson Hospital and Tumor Institute at Houston, Houston, Texas.
2 Radiotherapist, Department of Radiotherapy, M. D. Anderson Hospital and Tumor Institute at Houston.
The treatment policy for metastatic breast cancer at the M. D. Anderson Hospital combines local therapy, i.e., surgery and/or irradiation, with systemic therapy in three plans which emphasize the sequential use of agents. The choice of agents and the order of their use is dictated by the menopausal status of the patient, the biological behavior of the tumor and socioeconomic factors. Seventy-five percent of all cases receive some form of palliative radiotherapy.
Our policies, techniques and the results achieved with local management have been presented for the incurable primary lesion, chest wall recurrences, involvement of regional nodes and for distant metastases by systems. Treatment for metastases to the skeletal system has been described for the spine, pelvis, extremities, facial bones, ribs and for the surgical stabilization of fractures. Treatment for metastases to the central nervous system is described for the brain, cranial nerves, retina, spinal cord, and associated paraspinal tissues. Our experience in the management of other soft tissue sites is reported for intrathoracic and abdominal involvement including metastases to liver, scalp, orbit, etc. Final comments relate to radiation castration, retreatment of metastases, supportive medical management and management of necroses.
