No Chemo Necessary for Breast Cancer?

By Editorial Staff

At least not in the early stages of breast cancer, according to study findings published in The New England Journal of Medicine. Women with small tumors that had not spread beyond the breast tissue into the lymph nodes or beyond did as well or better without chemotherapy than women who did receive chemotherapy.

Researchers randomized breast cancer patients (more than 9,700 women ages 18-75 with estrogen-receptor-positive, HER2-negative cancer that had not spread) to receive chemotherapy and an estrogen-blocking medication or the medication only. All patients had already undergone surgery and radiation therapy, and had been evaluated to ensure their risk of cancer recurring was low enough to bypass chemotherapy. (Women at high risk for recurrence were advised to undergo chemo.)

Nine years after initial treatment, success rates were essentially equivalent between the two groups: 83.3 percent of women receiving the estrogen blocker were cancer free, compared to 84.3 percent of women receiving the medication and chemotherapy. Recurrence rates were also similar between groups: 95.0 percent of the medication / chemo group had no cancer recurrence at a distant site, versus 94.5 percent of the medication-only group.

The unpleasant side effects of chemotherapy have long plagued cancer patients: hair loss, nausea, vomiting and immune-system depression. This study suggests in at least some cases, these side effects may no longer be an issue. If you've recently been diagnosed with breast cancer, talk to your health care team about these findings and whether you may be a candidate for more conservative treatment options that do not require chemotherapy.