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    Chemo for Advanced Breast Cancer Might Be Enough

    Study finds no survival benefit in treating original tumor with surgery, radiation


    After an average of 17 months of follow-up, there was essentially no difference in survival between the women who had their original tumors removed and those who had not. There were 111 deaths in the group that had their breast cancers cut out compared to 107 deaths in the group that did not.

    Badwe said there is a tradeoff in these patients.

    Surgery and radiation can clear the tumor from the breast. That can be a big benefit for women who are bothered because they can feel the mass or if it has become ulcerated or broken through the skin, she said.

    But as in those early animal studies, Badwe and his team found that cutting out the breast tumor seemed to increase the growth of cancer at distant sites.

    "This is the first human study to show that," he said.

    Badwe said it's not clear why or how the primary tumor might control overall cancer growth. He said other studies would need to examine that.

    Another cancer expert said more research is needed to settle the issue.

    "I applaud the authors for doing this, but I don't think this is the last word," said Dr. Richard Bleicher, a breast surgeon at Fox Chase Cancer Center in Philadelphia.

    Bleicher said the relatively small number of patients didn't give the study enough power to show clear differences between the treatment options.

    A larger trial funded by the U.S. National Cancer Institute, which plans to enroll nearly 900 patients, is looking into the same question, he said. That study isn't due to wrap up until 2025, so it might be a while before doctors have more robust evidence.

    Studies presented at medical conferences are considered preliminary since they have not yet had the independent scrutiny required for publication in most medical journals.

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