ASTRO Patient Summary: Radiation is an Important Component of Therapy for Patients with Stage III Breast Cancer Who Achieve a Pathological Complete Response after Neoadjuvant Chemotherapy
Patients who present with locally advanced breast cancer (spread to local lymph nodes or local tissue) or large operable tumors are usually treated with chemotherapy prior to surgical removal of the tumor. In 15-20% of these patients, the surgically removed tissue is free of tumor because of the chemotherapy, which is referred to as "pathologic complete response", or pCR. Despite this, many of these patients will develop recurrences. This study looked at offering postoperative radiation to patients who achieved pCR as a way to decrease recurrences. The authors divided the results by stage of disease, because outcome varied depending on the stage. For stage I-II disease, the 10-year rate of freedom from recurrence for the radiation group was 100%, compared to 95% for the no radiation group. But a more significant result appeared in the stage III group, with a 10-year freedom from recurrence for the radiation group of 91% compared to 66% for the no radiation group. The authors conclude that all stage III patients who receive pre-operative (neoadjuvant) chemotherapy and achieve pCR should also receive post-operative radiation therapy.