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Recurrence Of Breast Cancer No Less If Chemo First

Timing of chemotherapy may not be as important as tumor characteristics in outcomes after lumpectomy for breast cancer, researchers found.
Neoadjuvant chemotherapy had no impact on locoregional recurrence compared with a strategy of surgery first in an analysis stratifying for the number of adverse factors present, Elizabeth A. Mittendorf, MD, of the MD Anderson Cancer Center in Houston, and colleagues found.
Nor was timing of chemotherapy a significant factor in the multivariate analysis, whereas tumor characteristics were, the group reported here at the Multidisciplinary Breast Cancer Symposium.
"The biology is really driving this more than the specific locoregional treatment that you choose," Mittendorf told MedPage Today.
The study included 2,984 women who underwent breast-conserving therapy at MD Anderson from 1987 through 2005.
Of the 22% who underwent neoadjuvant chemotherapy rather than surgery first, nearly all with clinical stage II/III disease (93%) saw a downstaging of their tumor, including pathologic complete response in 20%.
Patients who had chemotherapy first had somewhat poorer locoregional recurrence-free survival than those who had surgery first out to 10 years (90% versus 94%, P
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