Neoadjuvant chemotherapy prior to surgery can benefit women with lobular breast cancer

Researchers at the Medical University of Vienna have found that the breast of one in two women with lobular breast cancer can be preserved through chemotherapy prior to a breast operation.

"Up until now it had been the view that neoadjuvant chemotherapy hardly had any benefits in cases of lobular breast cancer due to the poor response rate of the cancer, however no one had yet examined the question of the breast preservation rate", says study leader Prof. Dr. Florian Fitzal from the University Department of Surgery, who also works at MedUni Vienna's interdisciplinary Breast Centre. "We were able to show that one in two women, who has this type of breast cancer and would really need complete removal of the breast, can keep the breast with the help of this treatment strategy.

The treatment is principally responsible for a sufficient reduction in size of the cancer, so that during the subsequent surgical excision, the breast could be then preserved in 48 percent of cases. The medium-term oncological certainty of breast preservation is also shown in this case. Only three percent have a local recurrence after five years, i.e. a tumour found at the same site. Therefore we should not rule out a prior neoadjuvant chemotherapy in cases of lobular breast cancer."

The effect is a marked improvement of the patient's quality of life. Fitzal says, "That was and still is our aim. We wanted to achieve this through the combination of the neoadjuvant therapy with the oncoplastic surgical methods, which are provided here in Vienna. We hope that anti-hormonal therapy prior to surgery will bring even further improvements." The study's results have now been published in the American specialist publication "Annals of Surgical Oncology".

Approximately every fifth patient suffers from lobular breast cancer, which is a less aggressive form than the more frequent ductal carcinoma. However, lobular breast cancer generally has more branches and the tumour is generally larger in terms of its diameter. Nodules are only palpable later in cases of lobular breast cancer. The consequence of this particular type of spreading is that the tumour is frequently only discovered when it is already at a locally advanced stage.