Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Estrogen-lowering drugs minimize surgery in breast cancer patients

21.05.2010
A nationwide study has confirmed the benefit of giving estrogen-lowering drugs before surgery to breast cancer patients. The treatment increased the likelihood that women could undergo breast-conservation surgery, also called lumpectomy, instead of mastectomy.

The study's chair, Matthew J. Ellis, MD, PhD, the Anheuser-Busch Endowed Chair in Medical Oncology and a breast cancer specialist with the Alvin J. Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine in St. Louis, will present the findings June 7 at the annual meeting of the American Society of Clinical Oncology.

Sponsored by the American College of Surgeons Oncology Group, the study took place at 118 hospitals across the country and involved 352 postmenopausal women with estrogen-receptor positive (ER+) breast tumors. The participants received aromatase inhibitors for 16 weeks before surgery for breast cancer, and the extent of their tumors was monitored before and after the drug treatment.

The lead investigator at the Washington University site was Julie A. Margenthaler, MD, assistant professor of surgery and a breast surgeon at the Siteman Cancer Center.

Aromatase inhibitors are also referred to as estrogen-lowering agents because they interfere with the body's production of estrogen, a hormone that stimulates the growth of ER+ breast tumors. ER+ is the most common breast cancer, accounting for three-quarters of cases.

All women in the study had stage II or III breast cancer, in which tumors are about an inch or larger in size and may have spread to the lymph nodes in the underarm area. Participants were placed in one of three groups at the study's start:

marginal, meaning breast-conservation surgery was possible but likely to be disfiguring or to require several surgical procedures;
mastectomy-only, meaning breast-conservation surgery was not possible; and
inoperable, meaning mastectomy would not completely remove the cancer.
After the 16-week aromatase inhibitor therapy, the women were reevaluated to see which surgical option was appropriate for them. The results showed that 82 percent of women in the marginal group, 51 percent in the mastectomy-only group and 75 percent in the inoperable group had successful breast-conservation surgery instead of mastectomy.

"Aromatase inhibitor therapy shrank the tumors in many of these women and improved surgical outcomes," Ellis says. "These results will encourage a change in practice across the country so that more women can benefit from the currently underutilized approach of administering estrogen-lowering agents before surgery."

The study participants were randomly assigned to receive one of three estrogen-lowering agents: exemestane (25 mg daily), letrozole (2.5 mg daily) or anastrozole (1 mg daily). No statistically significant difference in effectiveness was found among the three drugs.

Ellis explains that there are other benefits to using estrogen-lowering agents before surgery.

"ER+ breast cancer can be thought of as a chronic disease because patients generally take estrogen-lowering agents for many years after surgery to repress recurrence," Ellis says. "In other chronic diseases, such as hypertension or diabetes, a patient's response to treatment is continually monitored. But we've never done that with breast cancer. By treating breast cancer patients with estrogen-lowering drugs for three or four months before surgery, we can monitor treatment response and then specifically tailor surgical and post-surgical treatment based on this response."

Ellis, M. ACOSOG Z1031: A randomized phase II trial comparing exemestane, letrozole, and anastrozole in postmenopausal women with clinical stage II/III estrogen receptor-positive breast cancer. ASCO 2010 Annual Meeting. June 7, 2010.

Washington University School of Medicine's 2,100 employed and volunteer faculty physicians also are the medical staff of Barnes-Jewish and St. Louis Children's hospitals. The School of Medicine is one of the leading medical research, teaching and patient care institutions in the nation, currently ranked fourth in the nation by U.S. News & World Report. Through its affiliations with Barnes-Jewish and St. Louis Children's hospitals, the School of Medicine is linked to BJC HealthCare.

Siteman Cancer Center is the only NCI-designated Comprehensive Cancer Center within a 240-mile radius of St. Louis. Siteman Cancer Center is composed of the combined cancer research and treatment programs of Barnes-Jewish Hospital and Washington University School of Medicine.

Gwen Ericson | EurekAlert!
Further information:
http://www.wustl.edu

More articles from Health and Medicine:

nachricht Study tracks inner workings of the brain with new biosensor
16.08.2018 | Rheinische Friedrich-Wilhelms-Universität Bonn

nachricht Foods of the future
15.08.2018 | Georg-August-Universität Göttingen

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Unraveling the nature of 'whistlers' from space in the lab

A new study sheds light on how ultralow frequency radio waves and plasmas interact

Scientists at the University of California, Los Angeles present new research on a curious cosmic phenomenon known as "whistlers" -- very low frequency packets...

Im Focus: New interactive machine learning tool makes car designs more aerodynamic

Scientists develop first tool to use machine learning methods to compute flow around interactively designable 3D objects. Tool will be presented at this year’s prestigious SIGGRAPH conference.

When engineers or designers want to test the aerodynamic properties of the newly designed shape of a car, airplane, or other object, they would normally model...

Im Focus: Robots as 'pump attendants': TU Graz develops robot-controlled rapid charging system for e-vehicles

Researchers from TU Graz and their industry partners have unveiled a world first: the prototype of a robot-controlled, high-speed combined charging system (CCS) for electric vehicles that enables series charging of cars in various parking positions.

Global demand for electric vehicles is forecast to rise sharply: by 2025, the number of new vehicle registrations is expected to reach 25 million per year....

Im Focus: The “TRiC” to folding actin

Proteins must be folded correctly to fulfill their molecular functions in cells. Molecular assistants called chaperones help proteins exploit their inbuilt folding potential and reach the correct three-dimensional structure. Researchers at the Max Planck Institute of Biochemistry (MPIB) have demonstrated that actin, the most abundant protein in higher developed cells, does not have the inbuilt potential to fold and instead requires special assistance to fold into its active state. The chaperone TRiC uses a previously undescribed mechanism to perform actin folding. The study was recently published in the journal Cell.

Actin is the most abundant protein in highly developed cells and has diverse functions in processes like cell stabilization, cell division and muscle...

Im Focus: Lining up surprising behaviors of superconductor with one of the world's strongest magnets

Scientists have discovered that the electrical resistance of a copper-oxide compound depends on the magnetic field in a very unusual way -- a finding that could help direct the search for materials that can perfectly conduct electricity at room temperatur

What happens when really powerful magnets--capable of producing magnetic fields nearly two million times stronger than Earth's--are applied to materials that...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

VideoLinks
Industry & Economy
Event News

Within reach of the Universe

08.08.2018 | Event News

A journey through the history of microscopy – new exhibition opens at the MDC

27.07.2018 | Event News

2018 Work Research Conference

25.07.2018 | Event News

 
Latest News

Staying in Shape

16.08.2018 | Life Sciences

Diving robots find Antarctic seas exhale surprising amounts of carbon dioxide in winter

16.08.2018 | Earth Sciences

Protein droplets keep neurons at the ready and immune system in balance

16.08.2018 | Life Sciences

VideoLinks
Science & Research
Overview of more VideoLinks >>>