Adjuvant chemotherapy increases survival rates after resection of recurrent breast cancer

Chemotherapy after surgery, known as adjuvant chemotherapy, led to higher rates of disease-free and overall survival for women with isolated local or regional recurrence of breast cancer.

Patients who have isolated local and/or regional recurrence of their breast cancers are at high risk for developing metastases in other areas of the body. Some physicians prescribe chemotherapy for these patients after their recurrent tumors have been completely removed by surgery, but the efficacy of this treatment has not been studied until now.

“This is the first randomized controlled study that shows that adjuvant chemotherapy works in these patients,” said Stefan Aebi, MD, of Luzerner Kantonsspital in Luzern, Switzerland. He was the first author of this study, which evaluated 162 patients with isolated local and regional recurrence. Among these patients, 85 received adjuvant chemotherapy and 77 did not. The study involved the Breast International Group, the National Surgical Adjuvant Breast and Bowel Project, and the International Breast Cancer Study Group.

The 5-year disease-free survival rates were 69% for women who received adjuvant chemotherapy and 57% for those who did not. The overall survival rate was 88% for women who received adjuvant chemotherapy and 76% for those who did not.

The greatest benefit occurred in women with estrogen receptor (ER)-negative breast cancer, whose 5-year survival rate was 67% among those who received chemotherapy and 69% among those who did not. Also, for this group, the overall survival was 79% for those who received chemotherapy and 69% for those who did not.

For patients with ER-positive disease, the 5-year disease-free survival was 70% for those who received chemotherapy and 69% for those who did not. The ER-positive patients had an overall survival of 94% for those who received chemotherapy and 80% for those who did not.

Aebi recommended that physicians prescribe adjuvant chemotherapy for patients with isolated local and regional recurrence of breast cancer, especially if the recurrence is ER-negative and therefore not sensitive to endocrine therapy.

This research was presented at the CTRT-AACR San Antonio Breast Cancer Symposium, held December 4-8, 2012.
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