Long-term survival results favor chemotherapy before surgery for locally advanced disease.(breast cancer)

2002 MAY 30 - (NewsRx.com & NewsRx.net) -- Long-term survival results from a breast cancer treatment study begun in 1992 at the University of North Carolina at Chapel Hill's Lineberger Comprehensive Cancer Center strongly favor chemotherapy followed by surgery for women with large, locally advanced tumors.

Traditionally, women with breast cancer receive surgery followed by chemotherapy. However, the new findings also show that chemotherapy followed by surgery - neoadjuvant therapy - often allows less drastic and breast-sparing surgery, lumpectomy versus mastectomy.

Despite efforts at early detection, locally advanced breast cancer remains prevalent and is a challenge to control. In the past, many of these patients were considered inoperable because of the sheer volume of their tumors and the belief that they would soon die from spread of the disease well beyond the breast, or distant metastatic disease.

Over the last decade, studies of neoadjuvant therapy for patients with large primary tumors had demonstrated that successful tumor downstaging, or improvement, could result in increased rates of breast-conserving therapy. Moreover, a few reports indicated that tumors larger than 3 cm that were successfully downstaged with neoadjuvant chemotherapy could be controlled.

Still, the overall effect on long-term survival has remained unclear; the new findings help clarify this issue.

At a median follow up of 70 months, 76% of patients in the UNC study who received neoadjuvant therapy survived for at least of 5 years. Post-treatment follow-up ranged from 35 to 117 months.

In addition, neoadjuvant therapy may make surgery a viable option for women whose tumors were considered inoperable due to their seriously advanced stage, said Dr. William G. Cance, professor of surgery, chief of surgical oncology and a member of the cancer center.