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Study: Chemotherapy Effective Before or After Lumpectomy

A new study finds that long-term outcomes after breast-conserving surgery are the same, regardless of whether chemotherapy is given before or after surgery. Instead, the study suggests that biological factors have a greater impact than the time of chemotherapy. Breast-conserving surgery (also called lumpectomy) with chemotherapy may be a viable option for women with stage 2 or 3 breast cancers rather than mastectomy, according to the study.

The study included surveying almost 3,000 women treated for breast cancer at MD Anderson from 1987 to 2005. Seventy-eight percent of the women surveyed had surgery before chemotherapy and 22 percent received chemotherapy first. According to MD Anderson, 5 and 10-year outcomes were excellent for both groups. Of those who had surgery before chemotherapy, 97 percent were disease free without a cancer recurrence after 5 years, and 94 percent after ten years. For those who had chemotherapy before surgery, the disease-free, recurrence free survival rates were 93 percent after 5 years and 90 percent after 10 years. 

Chemotherapy resulted also resulted in 20 percent cancer-free cases and lowered cancer stage in almost half of patients who had Stage 2 or 3 cancer before chemotherapy, which the researchers say suggests that lumpectomy with chemotherapy may be an effective option for many women. 

“Even women who present with clinical Stage 2 or 3 breast cancer may have good results with breast-conserving surgery after chemotherapy and not need a mastectomy,” said Elizabeth Ann Mittendorf, M.D., assistant professor in the Department of Surgical Oncology and lead author of the study, in the center’s news release. “The molecular characteristics of the tumor and other factors have an impact on treatment success, but not the order in which chemotherapy and surgery are given.”

“Since 2005, treatment techniques have improved, including the ability to add targeted therapies to chemotherapy,” she said. “In the future we will look at the effects of newer agents, and we anticipate the results will be even more favorable for women who received these treatments before surgery.”

The results of the study were presented at the 2011 Breast Cancer Symposium.

Additional Resources and References

• The September 8, 2011 MD Anderson news release, “Chemotherapy is as Effective Before Breast Cancer Surgery as After,” was published at

• To learn more about chemotherapy, please visit