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The response rates in patients with breast cancer have improved over the last 10 years and are now close to 40%. However, despite this new effectiveness, the risk for patients to develop a second primary has increased to an average of 23% over the age of 50 years. This study was conducted to determine whether the protective effect of carboplatin and cyclophosphamide against radiation-induced morbidity could be detected at reduced doses. To determine this, the effects of low-dose carboplatin on the rate of development of breast cancer were compared with those of low-dose cyclophosphamide. To perform this comparative study, four hundred and eighty-nine women between the ages of 40 and 80 years were treated with six cycles of either cis-platinum, cyclophosphamide, or cyclophosphamide and thiotepa at median total doses of 300 mg/m2 and 14.2 mg/m2, respectively. After this relatively short follow-up period, 17.2% of the patients were identified as having developed a second primary or recurrence of breast cancer, whereas the expected values for the average age-matched group were 6.7% and 5.3%, respectively. The rate of second-primary and recurrence of breast cancer was significantly different in all treatment groups, but none of these differences was significant when the data were adjusted for time to recurrence and follow-up time. Patients treated with low-dose cyclophosphamide had a significantly lower recurrence rate compared with those treated with low-dose thiotepa. Low-dose cyclophosphamide does not offer protection against the development of breast cancer as has been suggested by other investigators.I suppose it’s an honor of some sort to be invited to the University of Georgia as a part of an extensive lecture series. My first lecture was Thursday night. I’ve been working with the secretary of state’s office on getting an event scheduled for the coming fall that could raise funds for their office. They were interested in letting me lecture and having a conversation with college students and local businessmen. I said I’d never spoken publicly before. Obviously, they were interested in more than just the talk though. They wanted to have a separate event with a few of the businesses that make up the UGA name.
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