In a nutshell
This study aimed to compare the effectiveness and safety of endocrine therapy (ET) or chemotherapy (CT) before surgery in patients with invasive ductal carcinoma (IDC) of the breast that is hormone receptor (HR) positive (+) and human epidermal growth factor receptor 2 (ERBB2) negative (-). The study concluded CT before surgery may be a better choice in these patients.
Some background
Breast cancer is one of the most common cancers affecting women worldwide. HR+ breast cancer cells grow in response to female sex hormones such as estrogen, progesterone, or both. HR+ tumors are likely to respond to ET (hormonal therapy). In ERBB2- breast cancer, the cells do not contain a high level of the HER2 protein which supports cancer cell growth.
In patients with invasive breast cancer such as IDC, the tumor may not be easy to remove during surgery. These patients can benefit from CT or ET before surgery to shrink the tumor. This is called neoadjuvant therapy. It is not known if neoadjuvant ET or CT are more appropriate for patients with IDC that are HR+ and ERBB2-.
Methods & findings
This study involved 640 patients with HR+/ERBB2- IDC that were planning to have surgery. 495 patients had CT and 145 had ET before surgery. The average follow-up time was 60.6 months for the CT group and 55.4 months for the ET group.
Patients in the CT group were 2.67 times more likely to have a longer overall survival compared to those in the ET group. This benefit for the CT group was seen regardless of age, menopause status, or breast cancer stage.
The bottom line
The authors concluded that CT before surgery should be the first choice for patients with HR+ and ERBB2-IDC.
The fine print
The study is limited only to an Asian population. Further studies included other populations are needed.
Published By :
JAMA network open
Date :
Mar 01, 2021
