Whether chemotherapy is given before or after breast-conserving therapy (BCT) does not have an impact on long-term local-regional outcomes, suggesting treatment success is due more to biologic factors than chemotherapy timing, according to a study by researchers at The University of Texas MD Anderson Cancer Center.
Presented today at the 2011 Breast Cancer Symposium, the study also found that neoadjuvant chemotherapy (given before surgery), often shrinks breast cancer tumors, making them more likely to be treatable with BCT, or a lumpectomy to remove a portion of the breast followed by radiation.
"Even women who present with clinical Stage 2 or 3 breast cancer may have good results with BCT after chemotherapy and not need a mastectomy," said Elizabeth Ann Mittendorf, M.D., assistant professor in the Department of Surgical Oncology and lead author of the study. "The molecular characteristics of the tumor and other factors have an impact on treatment success, but not the order in which chemotherapy and surgery are given."
The retrospective study of almost 3,000 women treated for breast cancer at MD Anderson from 1987 to 2005 also confirmed several prior studies showing BCT offers high rates of cancer control for certain patients.
Approaches have similar outcomes
Of the patients surveyed, 78 percent had surgery before chemotherapy and 22 percent received chemotherapy first. Overall, women with more cancers that had more adverse prognostic factors tended to be treated with chemotherapy first.
Five and 10-year local-regional recurrence-free survival rates were excellent for both groups: 97 percent and 94 percent respectively for those who had surgery before chemotherapy, 93 percent and 90 percent for patients who received chemotherapy first.
Mittendorf said that if adverse features, such as stage and grade of the cancer, age of the patient and tumor hormone expression, were factored in, survival rates were essentially the same for both groups of women.
Neoadjuvant chemotherapy resulted in complete pathologic response in 20 percent of patients and lowered cancer stage in almost half of patients who had Stage 2 or 3 cancer before chemotherapy, increasing the likelihood that BCT may be effective for many women after chemotherapy.
Carrying results forward
"This study shows that women appropriately selected for BCT, even some women with Stage 3 breast cancer, can have excellent rates of local-regional control," Mittendorf said. "The most important thing is putting all the factors together to determine who can most benefit from this approach."
The group plans to extend the study into MD Anderson patients treated after 2005.
"Since 2005, treatment techniques have improved, including the ability to add targeted therapies to chemotherapy," she said. "In the future we will look at the effects of newer agents, and we anticipate the results will be even more favorable for women who received these treatments before surgery."
Other MD Anderson team members included Thomas Buchholz, M.D., Department of Radiation Oncology; Susan Tucker, Ph.D., Department of Bioinformatics and Computational Biology; Funda Meric-Bernstam, M.D., Henry Kuerer, M.D., Ph.D., Isabelle Bedrosian, M.D., Gildy Babiera M.D., Merrick Ross, M.D. and Kelly Hunt, M.D., Min Yi, M.D., Ph.D., Department of Surgical Oncology; Ana Gonzalez-Angulo, M.D. and Gabriel Hortobagyi M.D., Department of Breast Medical Oncology.
Laura Sussman | EurekAlert!
Biofilm discovery suggests new way to prevent dangerous infections
23.05.2017 | University of Texas at Austin
Another reason to exercise: Burning bone fat -- a key to better bone health
19.05.2017 | University of North Carolina Health Care
Scientists have developed a new method of characterizing graphene’s properties without applying disruptive electrical contacts, allowing them to investigate both the resistance and quantum capacitance of graphene and other two-dimensional materials. Researchers from the Swiss Nanoscience Institute and the University of Basel’s Department of Physics reported their findings in the journal Physical Review Applied.
Graphene consists of a single layer of carbon atoms. It is transparent, harder than diamond and stronger than steel, yet flexible, and a significantly better...
The world's highest gain high power laser amplifier - by many orders of magnitude - has been developed in research led at the University of Strathclyde.
The researchers demonstrated the feasibility of using plasma to amplify short laser pulses of picojoule-level energy up to 100 millijoules, which is a 'gain'...
Staphylococcus aureus is a feared pathogen (MRSA, multi-resistant S. aureus) due to frequent resistances against many antibiotics, especially in hospital infections. Researchers at the Paul-Ehrlich-Institut have identified immunological processes that prevent a successful immune response directed against the pathogenic agent. The delivery of bacterial proteins with RNA adjuvant or messenger RNA (mRNA) into immune cells allows the re-direction of the immune response towards an active defense against S. aureus. This could be of significant importance for the development of an effective vaccine. PLOS Pathogens has published these research results online on 25 May 2017.
Staphylococcus aureus (S. aureus) is a bacterium that colonizes by far more than half of the skin and the mucosa of adults, usually without causing infections....
Physicists from the University of Würzburg are capable of generating identical looking single light particles at the push of a button. Two new studies now demonstrate the potential this method holds.
The quantum computer has fuelled the imagination of scientists for decades: It is based on fundamentally different phenomena than a conventional computer....
An international team of physicists has monitored the scattering behaviour of electrons in a non-conducting material in real-time. Their insights could be beneficial for radiotherapy.
We can refer to electrons in non-conducting materials as ‘sluggish’. Typically, they remain fixed in a location, deep inside an atomic composite. It is hence...
24.05.2017 | Event News
23.05.2017 | Event News
22.05.2017 | Event News
30.05.2017 | Life Sciences
30.05.2017 | Power and Electrical Engineering
29.05.2017 | Earth Sciences