LUMPECTOMY has become the standard treatment for early breast cancer in the US, but how - and whether - chemotherapy should fit into the process has been a matter of debate. The latest news is that women have a slightly better edge if they get chemotherapy after surgery and delay radiation therapy until later. That was the conclusion of an editorial in the New En gland Journal of Medicine which assessed the results of what it called the first and only published prospective trial designed to answer this crucial question about the order of treatments for early breast cancer.
Harvard doctors studied 244 women who had just had surgery for breast cancer and risked having tumours reappear. Half received chemotherapy before radiation and half after. The cancer ultimately spread to another site in the body in 36 per cent off the women who got radiation first, compared with 25 per cent of those who received chemotherapy first. The Journals editorial warned, however, that this is not the last word because more breast cancer cases need to be studied.