[Chemotherapy associated with surgery in advanced breast cancer (author's transl)].

Fifty patients with advanced breast cancer inoperable from the outset were treated at the Centre Antoine Lacassagne, Nice, with primary chemotherapy (3 cycles) followed by surgery (mammectomy dissection or Halsted). At the time of writing, the minimal follow-up period is 36 months. Detailed study of the various parameters initially present, clinical observations after chemotherapy and before surgery, and examination of surgical specimens have demonstrated the effectiveness of primary chemotherapy. Chemotherapy may be continued after surgery following the usual consolidation regimen and associated with local irradiation if required. The value of surgery lies in the irreplaceable information it provides on the nature and degree of local extension; it allows for optimization of complementary treatments whilst avoiding systematic procedures, such as local irradiation and, possibly, modified chemotherapy. The therapeutic solution proposed appears to be preferable to other treatments, including radiotherapy alone, chemotherapy plus radiotherapy, or surgery followed by radio -- and chemotherapy.