Cancer patients who receive neoadjuvant therapy followed by mastectomy may not need radiation

September 24, 2008

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.

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

Explore further: New ultrasound sensors for improved breast cancer screening

Related Stories

New ultrasound sensors for improved breast cancer screening

July 29, 2015

The first prototype ultrasound sensors for a new improved breast screening technique have been developed as part of a collaboration between the National Physical Laboratory (NPL), University Hospitals Bristol (UHB), North ...

NIST PET phantoms bring new accuracy to medical scans

July 29, 2015

Teaming with a medical equipment company, researchers at the National Institute of Standards and Technology (NIST) have demonstrated the first calibration system for positron emission tomography (PET) scanners directly tied ...

Is your fear of radiation irrational?

July 14, 2015

Bad Gastein in the Austrian Alps. It's 10am on a Wednesday in early March, cold and snowy – but not in the entrance to the main gallery of what was once a gold mine. Togged out in swimming trunks, flip-flops and a bath ...

Chemists are first to see elements transform at atomic scale

June 15, 2015

Chemists at Tufts University's School of Arts and Sciences, collaborating with PerkinElmer and UCL (University College London), have witnessed atoms of one chemical element morph into another for the first time ever—a feat ...

Recommended for you

Machine Translates Thoughts into Speech in Real Time

December 21, 2009

(PhysOrg.com) -- By implanting an electrode into the brain of a person with locked-in syndrome, scientists have demonstrated how to wirelessly transmit neural signals to a speech synthesizer. The "thought-to-speech" process ...

Quantum Theory May Explain Wishful Thinking

April 14, 2009

(PhysOrg.com) -- Humans don’t always make the most rational decisions. As studies have shown, even when logic and reasoning point in one direction, sometimes we chose the opposite route, motivated by personal bias or simply ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.