Short delay of chemo safe after breast surgery

NEW YORK (Reuters Health) - Research has shown that women who undergo chemotherapy after surgery for early-stage breast cancer have an improved chance of survival. Now, investigators have evidence that therapy can be safely delayed for up to 12 weeks - but waiting longer may adversely affect the outcome.

"Our findings can reassure women with early-stage breast cancer that it is okay to take some time before they start chemotherapy -- to gather information and be actively involved in treatment decision-making," lead author Dr. Caroline Lohrisch, from the British Columbia Cancer Agency in Vancouver, Canada, said in a statement.

The study, which is reported in the Journal of Clinical Oncology, involved an analysis of data for 2,594 women who underwent chemotherapy for early breast cancer at between 1989 and 1998. The women were divided into four groups based on the time between surgery and the start of chemotherapy: within 4 weeks, 4 to 8 weeks, 8 to 12 weeks, or 12 to 24 weeks.

No significant differences in survival were seen among the three groups that began chemotherapy within 12 weeks of surgery. By contrast, starting chemotherapy at greater than 12 weeks was associated with inferior survival.

Eighty-four to 89 percent of women who started chemotherapy within 12 weeks of surgery were alive 5 years later compared with 78 percent of women who began chemotherapy after 12 weeks.

Similarly, the percentage of women who were alive and had no evidence of cancer relapse after 5 years was also higher in the groups that started chemotherapy within 12 weeks.

"Based on currently available data, including the findings in this study, patients should be encouraged to start chemotherapy before more than 3 months have elapsed from surgery, to maximize the anticipated benefit," the researchers conclude. "The issue of timing between surgery and chemotherapy warrants further study, particularly in specific subgroups."

SOURCE: Journal of Clinical Oncology, October 20, 2006.