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DG DISPATCH - BREAST CANCER: Chemo May Not Be Necessary In Treatment Of Small Breast Tumors By Robert Carlson Special to DG News SAN ANTONIO, TX -- December 10, 1999 -- Successful treatment of small breast-cancer tumors may not require chemotherapy or hormonal therapy, according to an analysis of five recent large anticancer trials. The study found that women with tumors 1 cm or less in size did equally well after surgery, in terms of overall survival, whether they had chemotherapy or not. Use of chemotherapy after surgery for tumors 1 cm or less is a controversial issue, said Elizabeth Tan-Chiu, MD, Associate Director of the Medical Oversight Division, National Surgical Adjuvant Breast Project (NSABP), at the 22nd annual San Antonio Breast Cancer Symposium. There have been no clinical trials studying this specific group of women, she said, so this study examined data from five separate NSABP trials, which included a total of 1,260 women with tumors of this size. The NSABP is a cooperative group of research centers which pools its efforts to mount large clinical trials of cancer treatments. Dr. Tan-Chiu compared survival data over eight years between women who were treated by surgery alone, with data on women who had chemotherapy after surgery and with data on those who had chemotherapy combined with the hormonal treatment tamoxifen after surgery. She also looked at the number of cancer-free years, the time between surgery and recurrence of breast cancer (if any), in each of these treatment groups. Dr. Tan-Chiu found that adding chemotherapy improved cancer-free survival from 79 percent to 90 percent at two years in the group of 236 women who had tumors classified as estrogen receptor-negative (ER negative). Adding tamoxifen or a combination of tamoxifen plus chemotherapy to the treatment was found to improve cancer-free survival in the 1,024 women with tumors classified as estrogen receptor-positive (ER positive). Neither chemotherapy nor hormonal therapy significantly improved overall survival (regardless of whether the disease recurred or not) in either group. Eight-year survival was 92 percent overall, indicating a favorable prognosis for survival for these women with small tumors, Dr. Tan-Chiu reported. Related Link: Tamoxifen. E-mail this page to a friend or colleague! To print, use this version