Time of chemotherapy can not be as important that the characteristics of the tumor in the results after a Lumpectomy for breast cancer, researchers found.

Neoadjuvant chemotherapy had no impact on the locoregional recurrence compared to an intervention strategy for the first time in a class analysis of the number of adverse factors present, Elizabeth A. Mittendorf, MD, of MD AndersonCancer Centerin Houston, and colleagues.

Neither was both of chemotherapy an important factor in the multivariate analysis, whereas tumor characteristics were, the group reported here in the multidisciplinaryBreast cancerSymposium.

"Biology is really l & # 39; origin of this more than the specific locoregional you choose", said Mittendorf MedPage Today & # 39; today.

The study included 2984 women who underwent breast conserving surgery at MD Anderson from 1987 to 2005.

22% who underwent neoadjuvant chemotherapy instead of the first surgery, almost all with clinical stage II / III disease (93%) experienced a decrease in tumor stage, including pathological complete response in 20%.

Patients who had received chemotherapy first was a little worse locoregional recurrence-free survival than those who had the first surgery 10 years (90% versus 94%, P<0,001).

His distant metastasis-free survival and disease-specific survival was also worse compared to the first surgery (P<0,001).

However, the neoadjuvant group had a poor risk profile of basal, with:

• The youngest age

• More it's probably to have a clinical phase II or III disease

• nuclear grade 3

Estrogen receptor-negative disease •

Multivariate analysis identified these factors as well as multifocal disease, close or positive margins, lymphovascular invasion, estrogen receptor-positive disease not treated withhormoneso important for loco-regional recurrence-free survival.

The stratification of these factors, each level of risk of recurrence of regional shows of similar survival rates:

• Zero risk factors (p = 0.432)

• A risk factor (p = 0.889)

• Two risk factors (p = 0.216)

• Three risk factors (p = 0.804)

• Four risk factors (p = 0.262)

"properly some patients achieve a high rate of control locoregional with conservative treatment of the breast", concluded researchers.

Study commentator Barbara Fowble, MD, University of California, San Francisco, was asked if women with three or four risk factors should receive a breast-conserving surgery at all.

Women with three or four risk factors, failure locoregional ten years rose to 61% withBreast-conserving therapycompared to only 19% with mastectomy and radiotherapy in a previous study noted Fowble.

He urged the identification of women at risk of locoregional failure would be less in the mastectomy, customizing the decision based on factors for example initial tumor stage and molecular subtype.