Estrogen-lowering drugs minimize surgery in breast cancer patients

A nationwide study has confirmed the benefit of giving estrogen-lowering drugs before surgery to breast cancer patients. The treatment increased the likelihood that women could undergo breast-conservation surgery, also called lumpectomy, instead of mastectomy.

May 20, 2010

Physorg.com

The study’s chair, Matthew J. Ellis, MD, PhD, the Anheuser-Busch Endowed Chair in and a breast cancer specialist with the Alvin J. Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine in St. Louis, will present the findings June 7 at the annual meeting of the American Society of Clinical Oncology.

Sponsored by the American College of Surgeons Oncology Group, the study took place at 118 hospitals across the country and involved 352 with estrogen-receptor positive (ER+) . The participants received aromatase inhibitors for 16 weeks before surgery for breast cancer, and the extent of their tumors was monitored before and after the drug treatment.

The lead investigator at the Washington University site was Julie A. Margenthaler, MD, assistant professor of surgery and a breast surgeon at the Siteman Cancer Center.

Aromatase inhibitors are also referred to as estrogen-lowering agents because they interfere with the body’s production of estrogen, a hormone that stimulates the growth of ER+ breast tumors. ER+ is the most common breast cancer, accounting for three-quarters of cases.

All women in the study had stage II or III breast cancer, in which tumors are about an inch or larger in size and may have spread to the lymph nodes in the underarm area. Participants were placed in one of three groups at the study’s start:

  • marginal, meaning breast-conservation surgery was possible but likely to be disfiguring or to require several surgical procedures;
  • mastectomy-only, meaning breast-conservation surgery was not possible; and
  • inoperable, meaning would not completely remove the cancer.

After the 16-week aromatase inhibitor therapy, the women were reevaluated to see which surgical option was appropriate for them. The results showed that 82 percent of women in the marginal group, 51 percent in the mastectomy-only group and 75 percent in the inoperable group had successful breast-conservation surgery instead of mastectomy.

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Author: Leslie Carol Botha

Author, publisher, radio talk show host and internationally recognized expert on women's hormone cycles. Social/political activist on Gardasil the HPV vaccine for adolescent girls. Co-author of "Understanding Your Mood, Mind and Hormone Cycle." Honorary advisory board member for the Foundation for the Study of Cycles and member of the Society for Menstrual Cycle Research.