MedicineWorld.Org
Your gateway to the world of medicine
Home
News
Cancer News
About Us
Cancer
Health Professionals
Patients and public
Contact Us
Disclaimer

Medicineworld.org: Hormonal drugs minimize surgery in breast cancer

Back to breast cancer blog Blogs list Cancer blog  


Subscribe To Breast Cancer Blog RSS Feed  RSS content feed What is RSS feed?

Hormonal drugs minimize surgery in breast cancer




A nationwide study has confirmed the benefit of giving estrogen-lowering drugs before surgery to patients with breast cancer. The therapy increased the likelihood that women could undergo breast-conservation surgery, also called lumpectomy, instead of mastectomy.

The study's chair, Matthew J. Ellis, MD, PhD, the Anheuser-Busch Endowed Chair in Medical Oncology and a breast cancer specialist with the Alvin J. Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine in St. Louis, will present the findings June 7 at the annual meeting of the American Society of Clinical Oncology.



Hormonal drugs minimize surgery in breast cancer
Breast surgeon Julie Margenthaler, M.D., looks at a mammogram. Margenthaler was one of the lead investigators in a nationwide trial that tested how estrogen-lowering drugs before breast cancer surgery affected surgical outcomes.

Credit: Robert Boston


Sponsored by the American College of Surgeons Oncology Group, the study took place at 118 hospitals across the country and involved 352 postmenopausal women with estrogen-receptor positive (ER+) breast tumors. The participants received aromatase inhibitors for 16 weeks before surgery for breast cancer, and the extent of their tumors was monitored before and after the drug therapy.

The lead investigator at the Washington University site was Julie A. Margenthaler, MD, assistant professor of surgery and a breast surgeon at the Siteman Cancer Center.

Aromatase inhibitors are also referred to as estrogen-lowering agents because they interfere with the body's production of estrogen, a hormone that stimulates the growth of ER+ breast tumors. ER+ is the most common breast cancer, accounting for three-quarters of cases.

All women in the study had stage II or III breast cancer, in which tumors are about an inch or larger in size and may have spread to the lymph nodes in the underarm area. Participants were placed in one of three groups at the study's start:.
  • marginal, meaning breast-conservation surgery was possible but likely to be disfiguring or to require several surgical procedures;.
  • mastectomy-only, meaning breast-conservation surgery was not possible; and.
  • inoperable, meaning mastectomy would not completely remove the cancer.

After the 16-week aromatase inhibitor treatment, the women were rereviewed to see which surgical option was appropriate for them. The results showed that 82 percent of women in the marginal group, 51 percent in the mastectomy-only group and 75 percent in the inoperable group had successful breast-conservation surgery instead of mastectomy.

"Aromatase inhibitor treatment shrank the tumors in a number of of these women and improved surgical outcomes," Ellis says. "These results will encourage a change in practice across the country so that more women can benefit from the currently underutilized approach of administering estrogen-lowering agents before surgery".

The study participants were randomly assigned to receive one of three estrogen-lowering agents: exemestane (25 mg daily), letrozole (2.5 mg daily) or anastrozole (1 mg daily). No statistically significant difference in effectiveness was found among the three drugs.

Ellis explains that there are other benefits to using estrogen-lowering agents before surgery.

"ER+ breast cancer can be thought of as a chronic disease because patients generally take estrogen-lowering agents for a number of years after surgery to repress recurrence," Ellis says. "In other chronic diseases, such as high blood pressure or diabetes, a patient's response to therapy is continually monitored. But we've never done that with breast cancer. By treating patients with breast cancer with estrogen-lowering drugs for three or four months before surgery, we can monitor therapy response and then specifically tailor surgical and post-surgical therapy based on this response".


Posted by: Janet    Source




Did you know?
A nationwide study has confirmed the benefit of giving estrogen-lowering drugs before surgery to patients with breast cancer. The therapy increased the likelihood that women could undergo breast-conservation surgery, also called lumpectomy, instead of mastectomy. The study's chair, Matthew J. Ellis, MD, PhD, the Anheuser-Busch Endowed Chair in Medical Oncology and a breast cancer specialist with the Alvin J. Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine in St. Louis, will present the findings June 7 at the annual meeting of the American Society of Clinical Oncology.

Medicineworld.org: Hormonal drugs minimize surgery in breast cancer

BREAST CANCER MAIN| Home| Breast cancer news| Common terms| Breast cancer treatment| Breast cancer treatment by stage| Mammogram and breast cancer screening| Surgical treatment of breast cancer| Chemotherapy of breast cancer| Chemo drugs used in breast cancer| Doxorubicin| Cyclophosphamide| Methotrexate| Hormonal therapy of breast cancer| Radiation therapy of breast cancer| Monoclonal therapy| High dose chemotherapy for breast cancer| Recurrent breast cancer| Bisphosphonates and breast cancer| Pregnancy and breast cancer| Risk factors for breast cancer| Risk details| My risk| Comprehensive breast cancer information| Breast cancer statistics| African Americans and breast cancer| Ashkenazi and breast cancer| Asians| Hispanic| Men| Native Americans| Older women and breast cancer| Younger women| Pregnant women and breast cancer| BRCA|

Copyright statement
The contents of this web page are protected. Legal action may follow for reproduction of materials without permission.