Radiation prior to surgery reduces risk of secondary tumors in early-stage breast cancer

July 17, 2017, H. Lee Moffitt Cancer Center & Research Institute

Moffitt Cancer Center researchers launched a first of its kind study comparing the long-term benefits of radiation therapy in women with breast cancer either before surgery (neoadjuvant) or after surgery (adjuvant). Their study, published in the June 30 issue of Breast Cancer Research, found that patients who have neoadjuvant radiation therapy have a significantly lower risk of developing a second primary tumor at any site.

The majority of patients who have early stage have surgery to remove their tumor or a complete mastectomy. Surgery is commonly followed by , which has been shown to increase relapse-free survival. However, in some cases, patients may require neoadjuvant radiation therapy to decrease the size of the tumor before surgery. Currently, there are no studies that have analyzed the long-term effects of neoadjuvant radiation therapy on .

Moffitt researchers compared the overall survival and the time to diagnosis of a second tumor, if any, of 250,195 breast cancer patients who received either neoadjuvant or adjuvant radiation therapy. They analyzed patient outcomes from a National Cancer Institute (NCI) registry database of cancer incidence and survival rates in the United States. They included female patients in the analysis who were diagnosed between 1973 and 2011 with . The analysis included 2,554 women who received localized neoadjuvant breast radiation therapy before surgery and 247,641 women who received localized adjuvant breast radiation therapy after surgery.

The researchers discovered that among the breast cancer patients who tested positive for the estrogen receptor (ER) biomarker, patients who had neoadjuvant radiation therapy had a significantly lower risk of developing a second primary tumor than patients who had adjuvant radiation therapy. This was true for patients who underwent both partial and complete mastectomies. The researchers found that delaying surgery due to neoadjuvant radiation therapy was not a detriment to survival.

A number of recent studies have suggested that radiation therapy may re-educate and stimulate the immune system to target cancer cells. "The observed benefit of neoadjuvant radiation therapy aligns with the growing body of literature of the immune activation effects of radiation, including shrinking of untreated metastases outside the radiation field," explained Heiko Enderling, Ph.D., associate member of Moffitt's Integrated Mathematical Oncology Department.

These data are promising, but randomized clinical trials are needed to confirm the benefit of neoadjuvant radiation therapy. "Historic data indicate that disease-free survival is significantly increased when radiation is applied before surgery rather than after surgery, especially for ER-positive patients. These findings are worthy of a prospective clinical trial to confirm potential benefits of neoadjuvant vs. adjuvant radiation, and to identify the potential contribution of -induced immunity to vaccinate against future disease," said Enderling.

Explore further: Certain breast CA patients benefit from adjuvant capecitabine

Related Stories

Certain breast CA patients benefit from adjuvant capecitabine

June 1, 2017
(HealthDay)—Capecitabine (Xeloda) can extend the lives of patients with human epidermal growth factor receptor 2 (HER2)-negative breast cancer who have residual invasive disease after receipt of neoadjuvant chemotherapy, ...

Breast cancer prognosis of African-American patients may improve with chemotherapy before surgery

January 19, 2017
Administering chemotherapy to African-American breast cancer patients prior to surgery could improve their prognosis and survival rates from the disease, according to a new study.

Presurgical endocrine therapy less toxic than chemotherapy for ER-positive breast cancer

November 9, 2016
Neoadjuvant endocrine therapy - designed to reduce the size of breast tumors before surgical removal - appears to be as effective as neoadjuvant chemotherapy for patients with localized, estrogen-receptor (ER)-positive breast ...

Image-guided biopsy identifies patients who achieve pathologic complete response after neoadjuvant therapy

December 9, 2016
In a pilot study conducted at The University of Texas MD Anderson Cancer Center, image-guided biopsies identified select breast cancer patients who achieved pathologic complete response (pCR) after chemotherapy and/or targeted ...

Recommended for you

Compound in citrus oil could reduce dry mouth in head, neck cancer patients

May 21, 2018
A compound found in citrus oils could help alleviate dry mouth caused by radiation therapy in head and neck cancer patients, according to a new study by researchers at the Stanford University School of Medicine.

Ice cream funds research showing new strategy against thyroid cancer

May 21, 2018
Anaplastic thyroid cancer is almost uniformly fatal, with an average lifespan of about 5 months after diagnosis. And standard treatment for the condition includes 7 weeks of radiation, often along with chemotherapy.

Bladder cancer model could pave the way for better drug efficacy studies

May 21, 2018
Understanding that not all bladder cancers are the same, researchers at the University of North Carolina Lineberger Comprehensive Cancer Center have created a tool that may help them to uncover why only a fraction of patients ...

Breath test breakthrough for early diagnosis of oesophageal and gastric cancer

May 18, 2018
A breath test can successfully detect oesophageal and gastric cancer and could be used as a first-line test for patients, say researchers.

MR spectroscopy imaging reveals effects of targeted treatment of mutant IDH1 gliomas

May 18, 2018
Using a novel imaging method, a Massachusetts General Hospital (MGH) research team is investigating the mechanisms behind a potential targeted treatment for a subtype of the deadly brains tumors called gliomas. In their report ...

Particle shows promise to prevent the spread of triple-negative breast cancer

May 18, 2018
USC researchers have pinpointed a remedy to prevent the spread of triple-negative breast cancer. Metastatic breast cancer is a leading cause of death for women. The findings appear today in Nature Communications.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.