Surgery After Chemo and Radiation May Benefit Some Women

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A new study is an example of research that could possibly change the way breast cancer is treated. The results suggest that waiting to have surgery until after chemotherapy and targeted therapy medicine might benefit some women with breast cancer. But we just don't know enough right now to say with confidence that this approach is better than what is typically done today: surgery first, then other therapies.

It's been known for a while that African American women tend to be diagnosed with breast cancer at an earlier (often premenopausal) age than white women. African American women are also more likely to die from breast cancer than white women. In this study, the researchers were trying to understand why being diagnosed before menopause would increase a woman's risk of dying from breast cancer. The researchers looked to see if surgery played a role. Surgery is typically the first step in treating breast cancer.

The researchers suggest that cutting and removing a breast cancer may actually stimulate the growth of new blood vessels where the cancer was removed. Those new blood vessels may make it easier for another cancer to grow.

How is this related to African American women who are diagnosed with breast cancer before menopause? Younger women who are premenopausal usually have higher estrogen levels. The researchers think that the new blood vessel growth after surgery, combined with higher estrogen levels might work together to stimulate a cancer to come back and grow. This might explain why premenopausal African American women have a higher risk of dying from breast cancer.

At this point, it's just a hypothesis, which means that the researchers think it might be true but won't know for sure until more research is done.

Other research studies are evaluating targeted therapies to treat some breast cancers. One targeted therapy works by stopping new blood vessels from developing. Avastin (chemical name: bevacizumab) is an example of this type of targeted therapy. Avastin is approved by the U.S. Food and Drug Administration to treat advanced colon cancer. Early research results show that Avastin might help treat advanced breast cancer.

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