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Study supports tailoring adjuvant therapy for early-stage breast cancer

Premenopausal women with lymph node-negative breast cancer should receive adjuvant therapy tailored according to the estrogen receptor status of the primary tumor, concludes a study by the International Breast Cancer Study Group (IBCSG) reported in the December 17 issue of the Journal of the National Cancer Institute.

Patients with estrogen receptor (ER)-negative (i.e., endocrine nonresponsive) breast cancer should receive adjuvant chemotherapy, according to the study, whereas for patients with ER-positive (i.e., endocrine responsive) tumors, the use of endocrine therapy alone or in combination with adjuvant chemotherapy requires further study.

Some studies have suggested that cytotoxic chemotherapy benefits premenopausal women with breast cancer because it causes premature menopause. The new study addresses whether adjuvant ovarian function suppression can be used as a replacement for or as a supplement to cytotoxic adjuvant chemotherapy for premenopausal women with early-stage breast cancer.

These findings support the idea that ovarian suppression "is a viable treatment alternative for at least some premenopausal women with breast cancer," comment Joseph L. Pater, M.D., and Wendy R. Parulekar, M.D., of the National Cancer Institute of Canada Clinical Trials Group at Queen's University in Kingston, Ontario, in an accompanying editorial.

In the study, Monica Castiglione-Gertsch, M.D., and her colleagues from the IBCSG, compared outcomes of 1,063 pre- and perimenopausal women who were previously treated for lymph-node negative (early-stage) breast cancer and randomly assigned to receive adjuvant chemotherapy, adjuvant therapy with the ovarian function suppression drug goserelin, or adjuvant chemotherapy followed by goserelin. The women were tested to determine the estrogen receptor status of their tumors.

After a median follow-up of 7 years, there was no difference in disease-free survival or overall survival among patients in t
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Contact: Katherine Arnold
jncimedia@oupjournals.org
301-841-1287
Journal of the National Cancer Institute
16-Dec-2003


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