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Locoregional outcomes unaffected by timing of chemotherapy

Issue: September 25, 2011

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ASCO 2011 Breast Cancer Symposium

SAN FRANCISCO - Locoregional failures in patients who underwent breast-conservation therapy were not driven by the timing of chemotherapy, according to research presented here.

Elizabeth Mittendorf, MD, assistant professor in the department of surgical oncology at The University of Texas MD Anderson Cancer Center, and colleagues evaluated whether women undergoing breast-conservation surgery first or neoadjuvant chemotherapy first had better local control rates in the long term.

The study included 2,984 patients who underwent breast-conservation therapy and whole-breast irradiation from 1987 to 2005. They compared the outcomes of patients who underwent surgery first with the outcomes of patients who underwent neoadjuvant chemotherapy first. Most patients (78%) underwent surgery first.

The 5-year locoregional recurrence rate was 97% for women who underwent surgery first, and the 10-year rate was 94%. Among women who underwent chemotherapy first, the 5-year locoregional recurrence rate was 93%, and the 10-year rate was 90%. After adjusting for clinical stage at presentation, there were no differences in locoregional control between either group of women. Neoadjuvant chemotherapy lowered the cancer stage in nearly half of patients with stage II or III disease before chemotherapy, allowing breast-conservation therapy.

"Appropriately selected patients achieve high rates of local-regional control with breast-conservation therapy," Mittendorf said. "Local-regional recurrence after breast-conservation therapy is driven by biologic factors, not timing of chemotherapy."

For more information:

• Mittendorf E. #82. Presented at: 2011 Breast Cancer Symposium; Sept. 8-10; San Francisco.

Disclosure: Dr. Mittendorf reports no relevant financial disclosures.

Earn CME this spring at the HemOnc Today Breast Cancer Review & Perspective meeting to be held March 23-24, 2012 at the Hilton San Diego Bayfront. See details at HemOncTodayBreastCancer.com.

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