Randomised trials comparing pre- and postoperative chemotherapy in early breast cancer show similar rates of local control and overall survival, but the mastectomy rate is lower with the preoperative approach Fisher et al, Journal of Clinical Oncology 1998 ; . Existing studies show that patients with operable breast cancer who benefit the most from neoadjuvant chemotherapy are those who achieve a pathological complete response pCR ; with no residual microscopic tumour. These patients, representing 3-16% of the overall study population, have a statistically improved diseasefree survival DFS ; and overall survival OS ; compared to those with pathological evidence of residual cancer. In order to select such patients, it would be useful to be able to identify predictors of pCR prior to commencing treatment. Recent data Eular et al, Proceedings of the American Society of Clinical Oncology 2003 ; suggest that negative oestrogen receptor ER ; status may be such a predictor. This study looked at such a concept and at the effects of pCR on survival. Between 1985 and 2003, 435 suitable patients were identified who received neoadjuvant chemotherapy for operable breast cancer. Overall, the pCR rate was 12.
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29. Gwaltney JM, Hendley JO, Simon G. Rhinovirus infections in an industrial population. II. Characteristics of illness and antibody response. JAMA. 1967; 202: 494 Cloutier MM, Loughlin GM. Chronic cough in children: a manifestation of airway hyperreactivity. Pediatrics. 1981; 67: 6 Konig P. Hidden asthma in childhood. J Dis Child. 1981; 135: 10531055 Corrao WM, Sidney MD, Braman SS, Irwin RS. Chronic cough as the sole presenting manifestation of bronchial asthma. N Engl J Med. 1979; 300: 633 Morgan WJ, Taussig LM. The chronic bronchitis complex in children. Pediatr Clin North Am. 1984; 31: 851 Gwaltney JM, Hendley JO, Simon G, Jordan WS. Rhinovirus infections in an industrial population. JAMA. 1967; 202: 158 Mink CM, Cherry JD, Christenson P, et al. A search for Bordetella pertussis infection in university students. Clin Infect Dis. 1992; 14: 464 American Academy of Pediatrics. Pertussis. In: Peter G, ed. 1997 Red Book. Report of the Committee on Infectious Diseases. 24th ed. Elk Grove Village, IL: American Academy of Pediatrics; 1997: 394 397 Denny FW, Clyde WA, Glezen WP. Mycoplasma pneumoniae disease clinical spectrum, pathophysiology, epidemiology and control. J Infect Dis. 1971; 123: 74 Foy HM, Cooney MK, Maletzky AJ, Grayston JT. Incidence and etiology of pneumonia, croup and bronchiolitis in preschool children belonging to a prepaid medical care group over a four-year period. J Epidemiol. 1973; 97: 80 Foy JH. Infections caused by Mycoplasma pneumoniae and possible carrier state in different populations of patients. Clin Infect Dis. 1996; 17 suppl 1 ; : S37S46 40. Stevens D, Swift PGF, Johnston PGB, Kearney PJ, Corner BD, Burman D. Mycoplasma pneumoniae infections in children. Arch Dis Child. 1978; 53: 3842 Broughton RA. Infections due to Mycoplasma pneumoniae in childhood. Pediatr Infect Dis J. 1986; 5: 71 Nohynek H, Eskola J, Kleemola M, Jalonen E, Saiddu P, Leinonen M. Bacterial antibody assays in the diagnosis of acute lower respiratory tract infection in children. Pediatr Infect Dis J. 1996; 14: 478 Moss RB. Cystic fibrosis: pathogenesis, pulmonary infection, and treatment. Clin Infect Dis J. 1995; 21: 839, for instance, zestril mg!
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