Historically, if someone’s breast cancer was large, chemotherapy would commonly be given before the operation, to shrink the tumor and make it more operable. In some cases, this strategy would even shrink the tumor down from a mastectomy-sized mass to where it was a candidate for lumpectomy. The downside of this method, of course, is that it uses chemotherapy, which can be a pretty grueling experience for patients.
Can some women avoid pre-op chemo?
Now, a large clinical trial done in the U.S. indicates that there might be another, less punishing way to reduce the size of a tumor before operating on it. This study, published in the May 9 online edition of the Journal of Clinical Oncology, followed a patient population of post-menopausal women, all of whom had what’s called estrogen-receptive-positive tumors–tumors that grow faster in the presence of estrogen.
Estrogen boosts growth of many tumors
In fact, around 70 percent of breast cancers have an over-abundance of estrogen receptors on their surfaces, which means that they grow faster when exposed to the body’s naturally produced estrogen. (And even if a woman’s ovaries are “sleeping” or have been surgically removed, her adrenal glands are still very capable of manufacturing estrogen after ovarian function stops).
Hormonal therapy instead of chemo?
So, in this study, instead of giving these women chemo before they had their surgeries, the researchers tried placing them on an aromatase inhibitor, which is a hormonal therapy that blocks the synthesis of estrogen (less estrogen = less tumor growth). And guess what? The estrogen-lowering drugs shrank the tumors just as effectively as chemotherapy would have. Any time you can use less chemo, it’s a good thing.
Giving estogen-lowering drugs instead of chemo is exciting because if offers another option for shrinking tumors prior to surgery. This exciting advance will also
- improve the quality of life of women undergoing systemic treatment for breast cancer
- allow more women now facing mastectomy to become candidates for less-traumatic breast conservation