Some breast cancer patients who undergo chemotherapy before surgery have a greater chance of choosing procedures that preserve the breast rather than mastectomy, according to a recent study in the Journal of the American College of Surgeons.
The study, published online Feb, 26, was conducted by researchers from Yale University School of Medicine and Yale University Comprehensive Cancer Center in New Haven, Conn. Researchers also discovered that rates of chemotherapy rose significantly during the five-year period of the study, which they attributed to the possibility of better drugs approved by the FDA, according to an American College of Surgeons news release. The study is one of the largest so far on the topic of chemotherapy and breast cancer, the news release said.
Research included data from the National Cancer Data Base, which is a joint program of the Commission of Cancer and the American Cancer Society. Participants in the study included 354,204 women with invasive breast cancer who underwent breast surgeries and chemotherapy either before or after procedures, or both, between 2006 and 2011, the news release said.
Lumpectomy procedures, which more patients who receive chemotherapy are opting for, involve removing only the tumor and surrounding tissue, leaving the remaining breast tissue in tact.
“One interesting thing that we saw over time was that the percentage of women that did receive neoadjuvant therapy increased, going from 13.9% to 20.5% from 2006 to 2011,” Brigid K. Killelea, MD, MPH, FACS, lead investigator general surgeon said in the news release. “Those who received neoadjuvant chemotherapy were 70 percent more likely to have a lumpectomy for tumors larger than 3 centimeters (about 1.25 inches in diameter), leading to an increased rate of breast preservation. In other words, those people were able to avoid a mastectomy.”
As in past studies, the research showed a trend of higher rates of breast conservation for patient with larger tumors who first received chemotherapy, according to the news release. The study also showed that 35% of patients who had pre-surgery chemotherapy also had breast conservation therapy. Patients who avoided mastectomies included those with tumors as large as 4 to 8 centimeters, or about 3 inches in diameter, the new release said.
One advantage to chemotherapy before surgery is that it gives doctors an idea of how the tumor will respond to treatment, according to the news release. Pre-surgery chemotherapy also allows doctors to treat cancer that has spread to the lymph nodes right away so they don’t have to wait for the breast to heal after sugary, Killelea said in the news release.
“Going forward, it will be interesting to see whether or not the use of neoadjuvant therapy continues to rise as newer drugs and agents are being developed all the time,” Killelea said in the release. “It will also be interesting to watch what happens to the rate of breast conservation over time. We don’t know. That’s why it’s so important for us to have a database like NCDB.”
Read the full study here.