USA Today
Treating certain breast cancer patients with hormonal therapies before surgery can shrink tumors and allow some to avoid mastectomy, new research shows.
All the women in the study had tumors that were clearly or probably too big to be removed with lumpectomies, a less invasive operation that allows women to keep their breasts. And all had tumors that seemed to respond very strongly to estrogen.
Doctors gave everyone drugs called aromatase inhibitors, which reduce estrogen levels that feed many breast tumors, according to a study of 374 postmenopausal women. It was presented Wednesday at the 2010 Breast Cancer Symposium in Maryland.
After taking an aromatase inhibitor for 16 weeks, about half of women who would otherwise have had a mastectomy were able to have a lumpectomy instead, says study author John Olson, chief of breast surgery at Duke University. Among women with borderline tumors, who were likely to need a mastectomy, 82% were able to have lumpectomies.
The therapy didn't work for everyone. Tumors grew, rather than shrank, in 5% to 7% of of patients, depending on which of three types of aromatase inhibitors women took, Olson says. The therapy also won't work in women whose tumors don't respond to estrogen.
The study didn't include a comparison group of women given placebos.
In the future, Olson hopes to compare aromatase inhibitors with chemotherapy, which is now commonly used to shrink tumors before surgery. Until then, doctors won't be able to say for sure which drugs work best.
But aromatase inhibitors tend to be gentler than chemotherapy, says a Detroit cancer specialist, who wasn't involved in the new study.
Though aromatase inhibitors can cause hot flashes, joint pain, fatigue and bone loss, chemotherapy used to treat breast cancer can permanently damage heart muscle and kill vital immune cells, leaving women temporarily vulnerable to infections.
All the women in the study had tumors that were clearly or probably too big to be removed with lumpectomies, a less invasive operation that allows women to keep their breasts. And all had tumors that seemed to respond very strongly to estrogen.
Doctors gave everyone drugs called aromatase inhibitors, which reduce estrogen levels that feed many breast tumors, according to a study of 374 postmenopausal women. It was presented Wednesday at the 2010 Breast Cancer Symposium in Maryland.
After taking an aromatase inhibitor for 16 weeks, about half of women who would otherwise have had a mastectomy were able to have a lumpectomy instead, says study author John Olson, chief of breast surgery at Duke University. Among women with borderline tumors, who were likely to need a mastectomy, 82% were able to have lumpectomies.
The therapy didn't work for everyone. Tumors grew, rather than shrank, in 5% to 7% of of patients, depending on which of three types of aromatase inhibitors women took, Olson says. The therapy also won't work in women whose tumors don't respond to estrogen.
The study didn't include a comparison group of women given placebos.
In the future, Olson hopes to compare aromatase inhibitors with chemotherapy, which is now commonly used to shrink tumors before surgery. Until then, doctors won't be able to say for sure which drugs work best.
But aromatase inhibitors tend to be gentler than chemotherapy, says a Detroit cancer specialist, who wasn't involved in the new study.
Though aromatase inhibitors can cause hot flashes, joint pain, fatigue and bone loss, chemotherapy used to treat breast cancer can permanently damage heart muscle and kill vital immune cells, leaving women temporarily vulnerable to infections.
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