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Table 4. Response
Viens et al. 285
Number of Percentage of
évaluable patients responders
Objective clinical response 94 90 ± 6%
Pathologie response in breast 87 GR I and II: 32 ± 10%
GR III and IV: 68 ± 10%
GR I, disappearance of tumor on both macroscopic and microscopic examination; GR II,
presence of in situ carcinoma of the breast, with no invasive tumor; GR III, presence of
invasive carcinoma with stromal alterations such as sclerosis or fibrosis; GR IV, no or fe
alterations of tumoral appearance.
Thrombocytopenia of less than 20X10 9
/L occurred in 26 to 46% of cycles.
Duration of thrombocytopenia less than 20 X10 9
/L was a median 2 days per cycle,
with the same duration after each cycle. Platelet transfusions were needed in 29 to
56% of cycles, with administration of a median of one transfusion per cycle.
Chemotherapy delivery
A total of 366 cycles of chemotherapy were administered to 95 évaluable patients.
Median received dose intensity for cyclophosphamide and doxorubicin was 1211
mg/m 2
/week (range 50-1305) and 24 mg/m 2
/week (range 6-26) with respective
relative dose intensity of 0.97 (range 0.40-1.04) and 0.96 (range 0.25-1.05).
Anti-tumoral response (Table 4)
Clinical. Of the 94 évaluable patients, one had no clinical response after four
cycles of chemotherapy (persistence of inflammatory signs). All other patients had
a good clinical response to chemotherapy with complete disappearance of tumoral
signs (clinical complete response) in 75 (80%). After the first cycle of chemo­
therapy, 34 patients (41%) had a complete disappearance of inflammatory signs.
Pathological. One patient in clinical failure did not undergo mastectomy and
was evaluated as a pathologic failure. In eight other patients with good clinical
responses, mastectomy was not performed at their request. Limited local treatment
was given consisting of partial surgery and radiotherapy or radiotherapy alone.
These eight patients were not evaluated for pathologic response.
Eighty-six patients underwent mastectomy performed a median of 3.5 months
(range 3-9) after the first cycle of chemotherapy: 28 experienced complete
disappearance of tumor cells (grade I) or persistence only of an intraductal
component (grade II) (32 ± 10% of grade I or II pathologic response).