Giving chemotherapy before breast-conserving surgery is as effective against breast cancer recurrence as giving chemotherapy after breast-conserving surgery. These results were presented at the 2011 Breast Cancer Symposium.

Breast-conserving surgery (also referred to as lumpectomy) involves removal of the breast cancer and some surrounding normal tissue. For some women, giving chemotherapy prior to surgery can shrink the cancer and make it easier to remove. There’s been some uncertainty, however, about whether chemotherapy followed by breast-conserving surgery is as effective against local-regional recurrence (cancer recurrence in or near the breast) as breast-conserving surgery followed by chemotherapy.

To evaluate whether risk of breast cancer recurrence varies by timing of chemotherapy, researchers collected information about roughly 3,000 women who underwent breast-conserving surgery and radiation therapy between 1987 and 2005. Roughly three-quarters of the patients underwent surgery first and the remaining patients underwent chemotherapy first. Women who received chemotherapy first tended to have cancers with worse prognostic features.

  • Factors that were linked with an increased risk of breast cancer recurrence were young age (less than 50 years), clinical stage III cancer, grade 3 cancer, cancer that was estrogen receptor-negative, and close or positive surgical margins (cancer at or near the edge of the tissue that was surgically removed).
  • After accounting for tumor characteristics, risk of breast cancer recurrence was similar among women who underwent surgery first and women who underwent chemotherapy first.

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These results suggest that tumor characteristics—rather than the timing of chemotherapy—influence risk of breast cancer recurrence.

Reference: Mittendorf EA, Buchholz TA, Tucker SL et al. Impact of chemotherapy timing on local-regional failures in patients with breast cancer undergoing breast-conserving therapy. Paper presented at: 2011 Breast Cancer Symposium; September 8-10, 2011; San Francisco, CA. Abstract 82.

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