Study: Chemotherapy Before Surgery Improves Survival in Breast Cancer Patients

An observational study conducted by Italian researchers has found that breast cancer patients treated with chemotherapy before undergoing surgery to remove the tumor had a better rate of short- and long-term survival. In all, 213 patients diagnosed with triple-negative breast cancer were included in the study, which analyzed data collected from eight cancer centers across Italy.

Triple-negative breast cancer is one of the most aggressive forms of the disease, and patients have few options when it comes to treatment. According to one of the study’s co-authors, Dr. Maddalena Barba, a researcher at the IRCCS Regina Elena National Cancer Institute of Rome, approximately 10 to 15 percent of all breast cancer cases are identified as being the triple-negative type.

“Their aggressive behavior is well exemplified by the large tumor volume at presentation, along with the quite frequent involvement of regional lymph nodes, and high histological grade,” said Barba, whose paper was published in the Journal of Cell Physiology. While the five-year survival rate for patients diagnosed with other forms of breast cancer can be as high as 93 percent, the same survival measure for triple-negative breast cancer can be lower at 77 percent.

“Currently, there are no approved targeted therapies for triple-negative breast cancers and chemotherapy remains the mainstay of treatment,” said co-author Dr. Patrizia Vici, clinical researcher at the division of Medical Oncology 2 of the IRCCS Regina Elena National Cancer Institute. “When compared with other and more frequent breast cancer subtypes, these tumors show higher chemosensitivity, especially when chemotherapy is administered prior to surgery.”

In their real-life study, the researchers found that patients who were pre-treated with chemotherapy before surgery showed a 57.3 percent five-year disease-free survival rate. The overall survival after five years was found to be 70.8 percent.

“Results from our study confirmed previous findings from randomized clinical trials on the advantage conferred by more than six cycles of a well characterized regimen of neoadjuvant chemotherapy, that is, the sequential antracycline-taxane regimen,” said Giordano. “In addition, we confirmed the predictive role of some features related to the disease and its potential spread, namely Ki-67 absolute value and its relative measures, on treatment outcomes. Our work on triple negative breast cancer is thus confirmative in nature.”

Giordano stresses that while randomized clinical trials are important in assessing the efficacy of new cancer therapies, real-world observational studies also play an important role. “Indeed, breast cancer patients who participate in these trials are selected on the basis of well codified demographic, clinical, and molecular characteristics, which do not necessarily reflect those of patients from the real-world setting who represent the final recipients of our gains in cancer-related knowledge,” said Giordano.