Avm (adriamycin, vinblastine, methotrexate) neoadjuvant chemotherapy in advanced or inflammatory carcinoma of the breast.

Thirty-eight consecutive patients with locally advanced (stage IIIb/IVa-c) or inflammatory breast cancer (stage IVd) underwent neoadjuvant chemotherapy in our department between 1978-1990. All patients in this phase II study, received from three to five courses of neoadjuvant AVM regimen (Adriamycin, Vincristine, Methotrexate). Complete or partial response (CR+PR) was observed in 94.6% of this group of patients after the completion of therapy (chemotherapy + surgery + consolidation therapy) and in 97.3% at the completion of neoadjuvant chemotherapy alone. The overall 5-year median survival was 31.86% with a median disease-free time of 13 months. Only one patient showed progression of disease before surgery and was excluded from the study. The annual incidence of relapse in this study was 35% and the first metastatic event was observed locally in 1/4 of the patients examined. Low to moderate toxicity observed was reversible and easily controlled. We conclude that AVM neoadjuvant chemotherapy is a well tollerated regimen with long term clinical response in locally advanced breast cancer patients.