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ESMO 2017: Chemotherapy for Small Node-Negative Breast Tumors

Small breast tumors may be aggressive, and patients with these tumors may benefit from chemotherapy, according to a subanalysis of patients with pT1abN0 tumors enrolled in the MINDACT study, which was presented at the 2017 European Society for Medical Oncology (ESMO) Congress (Abstract 150O_PR). Biologic characteristics may be useful to determine the need for adjuvant chemotherapy for those with such tumors.

“Our results challenge the assumption that all small tumors are less serious and do not need adjuvant chemotherapy,” said lead author Konstantinos Tryfonidis, MD, a researcher at the European Organisation for Research and Treatment of Cancer (EORTC), Brussels, in a recent interview.

The subanalysis included 826 patients in the MINDACT trial who had a primary tumor size of less than 1 cm (pT1abN0). Nearly 200 patients were found to be at clinical low risk and genomic high risk. They were randomized to receive or not to receive chemotherapy. At 5 years, few patients who received chemotherapy had disease relapse. In addition, high rates of distant metastasis-free, disease-free, and overall survival seemed to confirm the benefit of chemotherapy in these patients.

In a recent interview, senior author of the study, Fatima Cardoso, MD, Director of the Breast Unit of the Champalimaud Clinical Centre in Lisbon, commented: “[A total of] 24% of small tumors had an aggressive biology, which shows that not all small tumors are the same.”



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