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

Sep 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: Physical exercise helps women with breast cancer to better tolerate chemotherapy

Related Stories

Ears, grips and fists take on mobile phone user ID

35 minutes ago

A research project has been under way to explore a biometric authentication system dubbed Bodyprint, with interesting test results. Bodyprint has been designed to detect users' biometric features using the ...

More than 2,200 confirmed dead in Nepal earthquake

41 minutes ago

A powerful aftershock shook Nepal on Sunday, making buildings sway and sending panicked Kathmandu residents running into the streets a day after a massive earthquake left more than 2,200 people dead.

Magnitude 6.7 aftershock hits Nepal, causes panic

1 hour ago

A powerful aftershock shook Nepal on Sunday, making buildings sway and sending panicked Kathmandu residents running into the streets a day after a massive earthquake left at least 1,900 people dead.

Nepal quake: Nearly 1,400 dead, Everest shaken (Update)

11 hours ago

Tens of thousands of people were spending the night in the open under a chilly and thunderous sky after a powerful earthquake devastated Nepal on Saturday, killing nearly 1,400, collapsing modern houses and ...

Russian hackers read Obama emails, report says

11 hours ago

Emails to and from President Barack Obama were read by Russian hackers last year in a breach of the White House's unclassified computer system, The New York Times said Saturday.

Recommended for you

'Chemo brain' is real, say researchers

11 hours ago

UBC research shows that chemotherapy can lead to excessive mind wandering and an inability to concentrate. Dubbed 'chemo-brain,' the negative cognitive effects of the cancer treatment have long been suspected, ...

User comments : 0

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.