Researchers at The University of Texas M. D. Anderson Cancer Center came to the surprising conclusion after discovering that chemotherapy response did not seem to impact survival in women with invasive lobular carcinoma the same way that it does for patients with invasive ductal carcinoma.
Results of the study show women with this lobular form of cancer may not need chemotherapy before surgery. "This is a striking finding, the first to find that in a type of breast cancer, response to chemotherapy seems to have little to do with long-term treatment success," says the study's lead author, Massimo Cristofanilli, M.D., associate professor in the Department of Breast Medical Oncology at M. D. Anderson.
The results came from a retrospective study of six clinical trials that treated 1,034 women with stage II and III invasive breast cancer (lobular or ductal) with primary chemotherapy in order to shrink their tumours before surgery.
"We always have thought that a poor response to chemotherapy always indicated a worse prognosis, but that is not true for every woman with breast cancer because this disease is quite heterogeneous," Cristofanilli says. "In fact, this study suggests women with invasive lobular carcinoma have a different kind of disease, and that they may benefit from a treatment that is more adequately tailored to the biology of their cancer.”
A change in the clinical approach may involve use of hormonal therapies, Cristofanilli says, because the team previously found that whether or not women with invasive lobular carcinoma achieved a complete response, they tended to have a better prognosis even compared with invasive ductal carcinomas that are hormone receptor positive (typically a better prognosis group).
MEDICA.de; Source: University of Texas M. D. Anderson Cancer Center