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Study Shifts Assessment of Certain Breast Cancer Patients

Conquest - Spring 2010

Early-stage breast cancer patients with HER2-positive tumors one centimeter or smaller are at significant risk of recurrence of their disease, compared to those with early-stage disease who do not express this aggressive protein.

Ana Gonzalez-Angulo, M.D.

In the first large study to analyze this population, results represent a shift in the way women with early-stage HER2-positive breast cancer should be assessed for risk of recurrence and considered for treatment, says the study’s senior author, Ana Gonzalez-Angulo, M.D, associate professor in
MD Anderson’s departments of Breast Medical Oncology and Systems Biology.

“Our findings show that women with early-stage HER2- positive breast cancer have a 23% chance of recurrence if the patient did not receive trastuzumab-based therapy. In contrast, the five-year survival rate of all women with such early-stage breast cancer is more than 90%,” Gonzalez-Angulo says.

“The findings indicate that physicians need to consider offering these women Herceptin-based therapy in the post-operative, or adjuvant, setting.”

Current guidelines call for no additional therapy after surgery and radiation if tumors are less than 5 millimeters. Herceptin-based adjuvant therapy should be discussed with patients if the tumors are from 6 millimeters to 10 millimeters, Gonzalez-Angulo explains.

Herceptin, also known as trastuzumab, is a monoclonal antibody that latches on to these proteins and inhibits tumor growth.

“The risk of recurrence was much higher than we suspected,” says Jennifer Litton, M.D., assistant professor in MD Anderson’s Department of Breast Medical Oncology, and an author on the study. “With this study, we now have evidence to discuss with our HER2-positive patients with even the smallest of tumors.

"Herceptin alone or combined with chemotherapy should be strongly considered as adjuvant therapy. This data should also encourage this subset of patients to be included in ongoing clinical trials with HER2-targeted therapies.”

The research was first presented at the CRTC-AACR San Antonio Breast Cancer Symposium in December 2008 and published online in November 2009 in the Journal of Clinical Oncology.

© 2015 The University of Texas MD Anderson Cancer Center