Early-Stage Breast Cancer Patients Who Receive Neoadjuvant Therapy

	Tweet

Early-Stage Breast Cancer Patients Who Receive Neoadjuvant Therapy Followed by Mastectomy May Not Need Radiation

Early-stage breast cancer patients who exhibit limited lymph node involvement may not require post-surgery radiation therapy (RT) when they receive neoadjuvant chemotherapy before a mastectomy, according to researchers from The University of Texas M. D. Anderson Cancer Center.

The findings were reported today at the 50th Annual meeting of the American Society for Therapeutic Radiology and Oncology.

“Radiation after surgery has been shown to benefit the survival of patients who have more advanced tumors,” said Tse-Kuan Yu, M.D., Ph.D., assistant professor in M. D. Anderson’s Department of Radiation Oncology. “However, administering neoadjuvant chemotherapy prior to surgery has changed how radiation oncologists need to approach treating patients with stage one and two breast cancers.”

The retrospective study led by Yu reviewed the cases of 427 women who underwent neoadjuvant chemotherapy and mastectomy from 1985-2004 to observe the value of treating early-stage breast cancer with RT. Of the 427 women, radiation was administered to 253 due to more aggressive tumor features. Those who received radiation more commonly had four or more pathologically involved lymph nodes or lymphovascular invasion.

Specifically focusing on those who did not receive RT, researchers looked at whether each patient’s breast cancer relapsed over the course of five years to determine if radiation contributed to preventing its return. Of the group of patients who were not treated with radiation, 20 percent of those with four or more pathologically involved lymph nodes after pre-surgery chemotherapy relapsed compared to 4.2 percent of those with one to three involved lymph nodes.

Interestingly, researchers noted that patients with zero involved lymph nodes after receiving chemotherapy prior to surgery exhibited a zero percent recurrence rate.

“Our findings indicate neoadjuvant chemotherapy controlled the cancer and radiation would have been unnecessary for patients with early-stage breast cancer and negative lymph nodes after neoadjuvant chemotherapy,” said Thomas Buchholz, M.D., Chair, Department of Radiation Oncology at M. D. Anderson, the study’s senior author. “Though additional research is warranted, we can begin to surmise that patients can be spared from radiation therapy if they have been treated with neoadjuvant chemotherapy and have less than three involved lymph nodes.”

By analyzing initial tumor characteristics in each patient, researchers can begin to classify which patients require post-mastectomy radiation to prevent recurrence. To expand on these findings, researchers at M. D. Anderson are planning future prospective clinical trials that would confirm whether radiation can be avoided in selected patients with early-stage breast cancer who are treated with neoadjuvant chemotherapy.

In addition to Yu and Buchholz, M. D. Anderson researchers contributing to this study include Elizabeth A. Mittendorf, M.D., Department of Surgical Oncology; Himanshu Nagar, Pepe Gomez, Eric A. Strom, M.D., George Perkins, M.D., Julia L. Oh, M.D., Welela Tereffe, M.D. and Wendy Woodward, M.D., Ph.D., all from the Department of Radiation Oncology.

About M. D. Anderson
The University of Texas M. D. Anderson Cancer Center in Houston ranks as one of the world’s most respected centers focused on cancer patient care, research, education and prevention. M. D. Anderson is one of only 41 Comprehensive Cancer Centers designated by the National Cancer Institute. For four of the past six years, M. D. Anderson has ranked No. 1 in cancer care in “America’s Best Hospitals,” a survey published annually in U.S. News and World Report.

Source: University of Texas M. D. Anderson Cancer Center

RELATED STORIES:
Breast cancer and pregnancy   An earlier start on diagnosing breast, prostate cancers   Dana-Farber study finds new points of attack on breast cancers not fueled by estrogen   Younger breast cancer patients have more adverse quality-of-life issues   In Breast Cancer, The Quality Of Life For Younger Patients More Adversely Affected Than For Older Women   Lack of social interaction affects health outcomes of breast cancer   Estrogen-Lowering Drugs Reduce Mastectomy Rates for Breast Cancer Patients   Breast cancer surgery patients benefit from adding radiation therapy   Breast cancer risk gene discovery fast tracked by new technology   RI Hospital first in country to enroll patient in new study for recurrent chest wall breast cancer   Ethnic breast cancer gap tied to mammography rates   IOM Report On Breast Cancer And The Environment   Genetic approach provides new insight into trastuzumab resistance in breast cancer   Large breast cancers persist despite screening   First prospective analysis links breast and pancreatic cancer risk with lynch syndrome   Computer Based Model Helps Radiologists Diagnose Breast Cancer   Mammograms under 50 optional for many women   In Flurry of Studies, Researcher Details Role of Apples in Inhibiting Breast Cancer   Scientists Break Genetic Code for Estrogen-Positive Breast Cancer   Breast Cancer Stories from U-M Cancer Center   Breast Cancer Patients Turn to Reflexology for Comfort   Study shows benefit of finding second tumor early

Comments

[ + Post Your Own ]

Now you're in the public comment zone. What follows is not Armenian Medical Network's stuff; it comes from other people and we don't vouch for it. A reminder: By using this Web site you agree to accept our Terms of Service. Click here to read the Rules of Engagement.

There are no comments for this entry yet. [ + Comment here + ]