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Poor response to chemotherapy does not mean poor outcome for patients with rare breast cancer

HOUSTON - Women with a rare type of advanced breast cancer who do not benefit from primary (pre-surgical) chemotherapy still have been found to do better in the long run than patients with a more common advanced breast cancer who do respond to chemotherapy.

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, the researchers report in January issue of the Journal of Clinical Oncology.

"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 tumors 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.

"Before this study, I don't think anyone realized the disease should be treated differently," Cristofanilli continues. "Now we need to think about revising our clinical approach and, more importantly, the way we communicate prognosis to women with l
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Contact: Laura Sussman
lsussman@mdanderson.org
713-792-0655
University of Texas M. D. Anderson Cancer Center
29-Dec-2004


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