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By Emma Patten-Hitt, PhD
WASHINGTON, Mar 20 (Reuters Health) - Giving chemotherapy to women with locally advanced breast cancer before surgery may help shrink the tumor and allow them to undergo breast conservation therapy (BCT) rather than a mastectomy, researchers report.
Dr. Lisa Newman and colleagues from the M.D. Anderson Cancer Center in Houston, Texas, presented the findings at the 54th annual cancer symposium of the Society of Surgical Oncology here on Saturday.
"Pre-operative chemotherapy in patients with locally advanced breast cancer is becoming the preferred and standard approach," Newman said. "It results in substantial tumor (shrinkage) in about 70% to 80% of patients, to the extent that many of the patients become candidates for BCT," she said. BCT includes removing only tumors and some surrounding tissue, and removing lymph nodes from the underarm area.
To evaluate how effective pre-operative chemotherapy is in allowing women to avoid mastectomy, Newman's team studied the treatment in 100 women with locally advanced breast cancer.
Before chemotherapy, 39% were deemed eligible for BCT, but after chemotherapy 59% of patients appeared eligible for the breast-sparing therapy. On average, tumor size was more than 2 centimeters before chemotherapy, but just 1 centimeter after chemotherapy, the researchers reported.
Still, Newman noted that improved imaging methods will be necessary to ensure accuracy in predicting whether women should undergo BCT. For this study, BCT-eligibility was determined by mammography and ultrasound, but magnetic resonance imaging (MRI) is a more sensitive test, according to Newman.
However, she told Reuters Health that "sometimes MRI can pick up lesions that are not clinically significant. It is also expensive and not available at every institution."
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