In a nutshell
The authors aimed to determine the advantage of neo-adjuvant (treatment given before surgery) therapies in terms of eligibility for certain surgeries.
Some background
Neo-adjuvant chemotherapy (NAC) is often provided to patients prior to surgery in an attempt to first shrink the tumor. This type of treatment is known to increase the likelihood of patient survival and reduce the risk of recurrence (the return of the cancer).
NAC also provides doctors with an insight into a patient’s prognosis (outlook). This can be valuable when deciding on which course of surgical treatment to begin. It also allows patient to undergo surgical treatments they may have originally not been candidates for.
Methods & findings
The aim of this review was to determine the value of NAC, particularly in relation to its effect on following surgical treatments.
One particular study randomly allocated women into two groups; NAC treatment and adjuvant chemotherapy (follows surgery). Of these women, initially only 3% were considered suitable to receive breast conserving therapy (BCT; removal of the tumor and some surrounding breast tissue) as they had larger tumors. Following NAC, 22% had successful BCT surgical treatments.
A review of 2983 patients found that 5-year local recurrence (return of cancer to the original tumor site) rates were not significantly different in patients who underwent NAC followed by BCT and those who had surgery first.
In another trial, neo-adjuvant endocrine (hormone) therapy was administered to 330 women. Women recieved either tamoxifen (Nolvadex) or anastrozole (Arimidex). Overall, 51% of patients originally needing mastectomies (removal of the entire breast) converted to receive BCT (a less invasive surgery).
The bottom line
The authors concluded that NAC can be useful in helping patients who would have needed a mastectomy to undergo BCT instead.
Published By :
Surgical oncology
Date :
Mar 13, 2014
