March 21, 2000
Cancer Information and Support International
One brief course of chemotherapy could greatly reduce the risk of recurrence in some women who have had breast-conserving surgery to treat their breast cancer, according to a new report.
In a study published in the March issue of the Journal of Clinical Oncology, researchers from the Netherlands Cancer Institute and the European Organization for Research and Treatment of Cancer found that for women under 43 years old whose breast cancer had not spread to their lymph nodes, one course of chemotherapy immediately after lumpectomy could reduce their risk of local recurrence of the cancer by more than threefold.
Local recurrence is the return of cancer to the site in which it originally occurred after it has been treated. In a local recurrence, there are no signs of cancer in nearby lymph nodes or tissue.
The researchers studied 361 premenopausal women with small (less than 3 centimeters), lymph node-negative breast cancer tumors who had been treated with breast-conserving therapy (BCT, or lumpectomy). Following surgery, 179 of the women (the "treatment group") were given a single course of chemotherapy within 36 hours. The other 182 women (the "control group") were not given chemotherapy. All women had radiation therapy within six weeks after surgery.
The investigators compared the local recurrence rates of the two groups, and also studied the effect that other factors -- including age, tumor type and size, and estrogen-receptor status (an index of responsivenss to hormonal therapy) -- had on the risk of local recurrence.
Young age was found to be the most significant risk factor for local recurrence - patients who were younger than 43 years old had an almost threefold increased risk of local recurrence (23 procent rate) compared with patients who were 43 or older (8 procent rate).
Brief post-op chemotherapy was found to significantly reduce the local recurrence risk. Patients who received this added treatment reduced their chances of local recurrence by more than 50 procent. The local recurrence rate after eight years was 20 procent for women who did not receive the chemotherapy, but only 10 procent for those who did.