A group of six Inova physicians have published a paper in the Annals of Surgical Oncology that could lead to re-thinking of treatment  practices for individuals with breast cancer. The paper, published in November 2020, details the results of a systemic literature review that included over 6,000 patient cases.

READ THE REPORT: Axillary Response in Patients Undergoing Neoadjuvant Endocrine Treatment for Node-Positive Breast Cancer: Systematic Literature Review and NCDB Analysis (Nov. 2020)

On review of the national database the team found that although endocrine therapy (also called “hormone therapy”)  works more slowly and so has not been used as much particularly in higher risk patients with positive axillary nodes, it had a very good success rate achieving a 14.4% pathologic complete response in clearing the axilla in patients with positive axillary nodes. This was higher than the success rate that was seen in previous smaller studies.

The team’s findings offer evidence that hormone therapy may offer a higher rate of success than previously believed, which could lead to it being offered more often to patients as a potential treatment option.

The researchers evaluated the impact of neoadjuvant endocrine therapy (NET) on axillary downstaging and surgical management. After a systemic review of the literature, the researchers discovered that patients who underwent neoadjuvant endocrine therapy for “node positive” (N+) breast cancer had a higher axillary pathologic complete response (pCR)* than previously reported in smaller studies. 

  * “Pathologic complete response” refers to an outcome whereby a patient who was given some form of therapy prior to surgery is then shown to have no cancer cells present in tissues that, prior to the therapy and surgery, did contain cancer cells.

Contributors from Inova:

  • Kirsten Edmiston, MD (Inova Medical Group – Breast Surgery, Inova Schar Cancer Institute)
  • Costanza Cocilovo, MD (Inova Medical Group – Breast Surgery, Inova Schar Cancer Institute)
  • Robert Cohen, MD (Inova Medical Group – Breast Surgery, Inova Schar Cancer Institute)
  • Sara Bruce, MD (Inova Breast Care Institute/ Inova Alexandria Hospital)
  • Lucy De La Cruz, MD (Inova Medical Group – Breast Surgery, Inova Schar Cancer Institute)
  • Arielle Stafford (Surgical Chief Resident, Inova)

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