When should chemotherapy be given to treat breast cancer?

Originally posted in Insidermedicine

Giving breast cancer patients chemotherapy before hormone-suppressing therapy with tamoxifen may improve their prognosis, but only if they are at high risk for a cancer recurrence, according to research published in The Lancet.

Here is some information about the treatment of breast cancer:

• Surgery is usually the first line of attack against breast cancer. It might involve removal of a lump, a breast, or breast plus lymph node tissue

• Some patients receive chemotherapy, either before or after surgery

• For those whose cancer is fed by hormones, drugs that suppress hormones, such as tamoxifen, are frequently given

Researchers from the Loyola University Chicago Stritch School of Medicine in Maywood randomly assigned over 1,500 postmenopausal women with breast cancer that had spread to their lymph nodes to one of three treatment regimens. One group received tamoxifen alone, another received tamoxifen and chemotherapy at the same time, and a third received chemotherapy followed by tamoxifen. After a maximum of 13 years of follow-up, the chemotherapy followed by tamoxifen treatment regimen was associated with the lowest cancer recurrence rates.

The same group of researchers then conducted genetic testing on samples of tumors taken from 367 patients. These tumors were tested for the presence of 21 genes that are known to influence a patient’s risk of having a cancer recurrence. The tests revealed that, among women with a low chance of cancer recurrence, adding chemotherapy to their tamoxifen treatment provided no benefit. Among those with a high risk of recurrence, however, the chemotherapy helped reduce their risk.

Today’s research can help health care professionals appropriately plan treatment for breast cancer, identifying who is most likely to benefit from chemotherapy and how best to administer it.

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