Chemotherapy is as effective before breast-conserving therapy (BCT) as it is after it, a new study has suggested.
The study also found that neoadjuvant chemotherapy (given before surgery), often shrinks breast cancer tumours, making them more likely to be treatable with BCT, or a lumpectomy to remove a portion of the breast followed by radiation.
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.
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.
Elizabeth Ann Mittendorf, M.D., assistant professor in the Department of Surgical Oncology and lead author of the study, 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.
"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," she said.
"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," she added.
The study was recently presented at the 2011 Breast Cancer Symposium.