Doctors have found a new way to assess small breast cancer lumps
and can now more reliably predict whether women will live or die of
the disease.
In a large-scale study of women with tumors smaller than 14
millimeters, published in The Lancet, scientists have found that
women who have calcium deposits on their tumors have only a 55 per
cent chance of survival over 20 years, compared with 95 per cent
for all other tumors.
Cancer specialists believe the novel method of assessment will
change the way thousands of women are treated for the disease. It
will stop many women receiving unnecessary drugs or chemotherapy,
as well as identifying those who may need more aggressive
treatment, they said.
In Britain breast cancer is one of the most common forms of
cancer in women and is the leading cause of death in women over the
age of 35. One in 11 women in this country will develop breast
cancer at some point in their lifetime, and 33,000 women are
diagnosed each year.
Currently women who are diagnosed with small breast cancer lumps
are all treated with either drugs or chemotherapy, both of which
have severe side-effects such as hair loss and nausea.
Dr. Laszlo Tabar, of the Falun Central Hospital in Sweden and
co-author of the study,called for a re-evaluation of the way
doctors assessed early onset of the disease.
``A large group of women are in danger of overtreatment,'' he
said. ``Small breast cancers should be treated by criteria
established especially for this size range and taking the
heterogeneity of breast cancers into account.''
The 343 women in the study were divided into sub-groups
depending on the size of the tumor and the number of calcium
deposits. Nearly one in seven women who had a tumor of less than 9
millimeters -- 30 per cent of all those diagnosed with breast cancer
-- had a lump with calcium deposits, and they accounted for 73 per
cent of all deaths.
Prof. Charles Coombes, director of the Cancer Research
Campaign's laboratories at the Hammersmith Hospital, Imperial
College London, and one of the country's leading experts on breast
cancer, said: ``This is a very interesting finding which could
alter the way women with small breast cancers are treated. The
findings need to backed up with a larger study but could mean that
women who have a very good chance of survival, those with very
small cancers without calcification, are having unnecessary
chemotherapy because at the moment no one knows whether or not the
cancer will return.
``In the same way those identified as high risk could have more
aggressive treatment to improve their chances of survival.'' t
Research published in the British Medical Journal shows for the
first time that hormone replacement therapy has no effect on the
outcome of breast cancer. Previous research has suggested that
women on HRT have a better chance of survival.
However, Dr. Sheila Stannard, of the North Glasgow Hospitals
Trust, who studied more than 1,100 women, found that HRT had no
effect, favorable or negative, on women who develop breast cancer.
``Our results do not support the commonly held view that women
using hormone replacement therapy develop tumors with favorable
prognostic features,'' she said. ``We show that women using hormone
replacement do not develop poorer prognosis tumors, and this is
reassuring to doctors prescribing HRT.''
