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Home News and Update Year 2013 If Breast Cancer Spreads, Surgery Can’t Prolong Life - Study

If Breast Cancer Spreads, Surgery Can’t Prolong Life - Study

Chemo Gives Similar Result: Hosp

Surgery and radiotherapy do not necessarily ensure longer survival for women with metastatic breast cancer (MBC) — cancer that has spread to other vital organs in the body. Chemotherapy and hormonal treatment can achieve almost similar benefits, a landmark study by Parel’s Tata Memorial Hospital (TMH) has established.

The study, presented in the ongoing San Antonio Breast Cancer Symposium in US, could alter the way metastatic breast cancer is managed and save many patients from needless surgery or exposure to radiation.

It also solves the dilemma most cancer surgeons face when presented with MBC. In 5–20% of breast cancer patients, the cancer has already attacked other vital organs by the time of their first visit to a doctor. In India, where there’s a dearth of preventive screening programmes, a significant majority of women get diagnosed for breast cancer long after the cancer has spread.

The trial involving 350 women was carried out between February 2005 and May 2013, where they were divided into two groups. One group had 173 women, who underwent surgery and radiotherapy, while another group of 177 women were spared these. Both groups had undergone six successful rounds of chemotherapy before their recruitment into the trial. Women who underwent surgery had the primary breast tumour, where the cancer had originated, and lymph nodes removed, followed by several weeks of radiation.

If Breast Cancer Spreads, Surgery Can’t Prolong Life - Study

The average survival rate for both groups was found to be between 18 to 20 months. "We found there was no difference in overall survival between those who received loco–regional treatment (surgery and radiation) and those who did not," said Dr Rajendra Badwe, director of TMH, in a statement. "A lot of oncologists who believe in conventional wisdom and don’t provide loco–regional treatment will feel a lot more comfortable looking at the results." In fact, there was an insignificant 7% excess death rate noted in patients who underwent surgery and radiotherapy.

The findings could change the way metastatic cancer is handled the world over. At least 30–50% of patients diagnosed with MBC are given the surgical option. "The efficacy of surgery and radiation was always a debated area as most studies were retrospective and gave conflicting results," said Dr Sudeep Gupta, TMH professor of medical oncology.

Tata Hospital had stopped operating on MBC patients long ago. "Many more women would be spared the anxiety of undergoing a breast removal surgery," Gupta added.

Ashwini Budrukkar from the hospital’s department of radiation oncology said in cases where patients are advised surgery and radiation, the patients easily spend around 2–3 months for surgery and radiation sessions. "We will not only be saving resources, but patients, too, will be relieved of a financial burden," she said.

Badwe added that treatment options like surgery and radiotherapy should be reserved for palliative reasons.

  • Patients of metastatic breast cancer (when the cancer has spread) may not benefit from surgery and radiotherapy after chemotherapy, shows a Tata Memorial Hospital study
  • For 5–20% breast cancer patients, it’s already spread when they approach doctors
  • For study, 350 patients were divided into two groups — one underwent surgery and received radiotherapy, the other didn’t
  • Survival rate for both groups averaged 18.8–20.5 months
  • Overall survival after two years was 40% in surgery group and 43.3% in the one that didn’t
  • Findings can change how metastatic breast cancer is managed the world over
  • Patients may be saved expensive, avoidable surgeries and radiotherapy
  • Resources and time needed for radiotherapy lasting up to five weeks and probable side–effects can be saved
  • Globally, up to 40% patients diagnosed with metastatic breast cancer are known to opt for partial or complete breast removal
  • Should not give impression that metastatic breast cancers are not treatable
  • There are advanced chemotherapy drugs, hormonal as well as targeted therapies that give good results
  • Survival rate in the study group ranges from 8 months to 7 years
  • Findings relevant for metastatic breast cancer, not other cancers
Times of India
13 Dec 2013,
Mumbai, India
by - Sumitra Deb Roy

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