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Definitive study confirms chemo benefit in postmenopausal breast cancer
Date:12/10/2009

ast cancer cases in the U.S.

"There's nothing magic about the biology being different in lymph node-negative versus lymph node-positive breast cancer," says Albain. When it comes to predicting benefit from chemotherapy, "our data suggest that it doesn't seem to matter whether the lymph nodes are involved or not, but the recurrence score on the genetic assay does matter. It identifies for us a group of patients who have a distinct tumor biology, for whom chemotherapy may not reduce the chances of recurrence even though their risk is high."

Currently, several months of chemotherapy after surgery is the standard of care for a patient with node-positive breast cancer, regardless of the hormone receptor or other biomarker status in her tumor tissue. Indeed, chemotherapy in this setting has been credited in part for a marked decline in breast cancer mortality over the last 20 years. But if validated by later studies, the results reported by the SWOG investigators would mean that many of these patients are being treated needlessly, since they do not benefit from the chemotherapy.

The researchers stress that these results only pertain to patients with estrogen receptor-positive breast cancers, and that more work needs to be done to confirm the findings before doctors change clinical practice based on them.

"Many aspects of this retrospective study introduce uncertainty into our results and make our conclusions tentative," says Dr. Daniel Hayes of the University of Michigan Medical School, who was senior author on the Lancet Oncology study. "Prospective studies with larger sample sizes are needed to determine who will benefit from chemotherapy added to hormonal therapy and who should avoid chemotherapy altogether."

Hayes adds that the Southwest Oncology Group is now designing such a study.


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Contact: Frank DeSanto
fdesanto@umich.edu
734-998-0114
University of Michigan Health System
Source:Eurekalert

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