Phase III trial comparing two dose levels of epirubicin combined with cyclophosphamide with cyclophosphamide, methotrexate, and fluorouracil in node-positive breast cancer.

Purpose: To compare a full-dose epirubicin-cyclophosphamide (HEC) regimen with classical cyclophosphamide, methotrexate, and fluorouracil (CMF) therapy and with a moderate-dose epirubicin-cyclophosphamide regimen (EC) in the adjuvant therapy of node-positive breast cancer.

Patients And Methods: Node-positive breast cancer patients who were aged 70 years or younger were randomly allocated to one of the following treatments: CMF for six cycles (oral cyclophosphamide); EC for eight cycles (epirubicin 60 mg/m(2), cyclophosphamide 500 mg/m(2); day 1 every 3 weeks); and HEC for eight cycles (epirubicin 100 mg/m(2), cyclophosphamide 830 mg/m(2); day 1 every 3 weeks).

Results: Two hundred fifty-five, 267, and 255 eligible patients were treated with CMF, EC, and HEC, respectively.

[Bilateral breast masses].

A 76 year old woman is hospitalized for bilateral breast masses and neurological impairment. Her medical history is marked by rheumatoid arthritis treated with gold salts and methylprednisolone. Blood tests reveal pancytopenia; the MRI scan of the brain is suggestive of a CNS lymphoma.

[Interstitial pneumopathy caused by melphalan].

The Authors have described a case of interstitial pneumonia due to 1-phenyl alanine (Melphalan). This case report, where a diagnosis of myeloma of the lung was excluded, was characterised by contact with a single cytotoxic agent in low doses and a short delay before the appearance of the pneumopathy. The different cytotoxic substances capable of inducing such pulmonary lesions are recalled as well as the mechanisms responsible for the phenomenon.