What is adjuvant therapy for breast cancer?

Updated: May 21, 2019
  • Author: Erin V Newton, MD; Chief Editor: Neetu Radhakrishnan, MD  more...
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Answer

Answer

Adjuvant treatment of breast cancer is designed to treat micrometastatic disease, or breast cancer cells that have escaped the breast and regional lymph nodes but have not yet established an identifiable metastasis. Depending on the model of risk reduction, adjuvant therapy has been estimated to be responsible for 35-72% of the reduction in mortality rate.

However, genomic analysis may identify patients whose risk of metastasis is low even if they do not receive adjuvant treatment. In the MINDACT study, which used a 70-gene signature test (MammaPrint) to identify1550 women with early-stage breast cancer who were at high clinical risk but low genomic risk for recurrence, those patients who did not receive chemotherapy had a 5-year rate of survival without distant metastasis of 94.7% (95% confidence interval, 92.5% to 96.2%). That rate was 1.5 percentage points lower than the rate in woment who did receive chemotherapy.  The MINDACT investigators concluded that approximately 46% of women with breast cancer who are at high clinical risk might not require chemotherapy. [1]

A study by King et al found that the low rates of occult contralateral breast cancer do not support the use of contralateral prophylactic mastectomy in average-risk women with newly diagnosed breast cancer. [2]


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