Cancer Advances: Following Treatment Guidelines Improves Breast Cancer Survival

Posted online on August 2, 2004 on www.jco.orgRead the original studyA new study shows that following established guidelines when giving drug therapy after surgery to women with early stage breast cancer helps women to live longer and reduces the risk of the cancer returning.In the new study, researchers examined the medical records of more than 1,500 women in Quebec, Canada who were diagnosed between 1988 and 1994 with breast cancer that had not spread to nearby lymph nodes.Researchers compared the treatment breast cancer patients received after surgery to the treatment guidelines available at the time. The guidelines, developed by cancer specialists during a 1992 medical conference in Switzerland and updated regularly, are considered an excellent reference for treating patients with early breast cancer. They indicate whether after surgery, women should receive the drug tamoxifen, chemotherapy, neither (for women at low risk for recurrence), or both, depending on the extent of the cancer.Overall, researchers found that women who were on treatment that followed the guidelines lived longer than women whose treatment did not follow guidelines - especially women at moderate risk for recurrence. For women at moderate risk for breast cancer recurrence, 88% of those whose treatment followed the guidelines were alive after seven years, compared to 79% of those whose treatment differed from the guidelines.In addition, more women whose treatment differed from guideline recommendations experienced a recurrence of their cancer within seven years of diagnosis compared to women whose therapy followed the guidelines.Underuse of therapy exists to some degree - at any cancer center - due to the complex nature of cancer care. For example, a physician may choose not to prescribe therapy after surgery if the patient is expected to fare well without it. Such a decision is often made to avoid the harsh side effects associated with the therapy itself. Sometimes the presence of other medical conditions may also influence a physician's choice or a patient's decision about certain treatments.What Does This Mean for Patients?When discussing breast cancer treatment options with your doctor, ask whether the treatment follows current guidelines. In some cases - such as when side effects may be too severe for a particular patient to handle - doctors' treatment recommendations may differ from guidelines, but patients should know why their treatment does or does not follow these recommendations.