Breast Cancer: The Importance of Local Control

Award-winning work by Dr. Marie Overgaard, of the Department of Oncology, Aarhus University Hospital, Denmark, gives new hope of longer survival for women with breast cancer. Dr. Overgaard’s work shows that treating the primary tumor with an optimal combination of surgery, radiotherapy and adjuvant chemotherapy markedly reduces the risk of local recurrences. Dr. Overgaard therefore calls for the reversal of current trends towards less aggressive local treatment for primary breast cancers.

Over the past 25 years, major improvements in survival from breast cancer have been achieved by giving adjuvant therapy,” said Dr. Overgaard at the 1997 European Cancer Conference. “But, paradoxically, there has been a tendency to treat the primary tumor less aggressively than before, on the basis that breast cancer is a systemic disease and that local treatment to the primary tumor will not affect survival.”

The Danish Breast Cancer Trials show that this view is mistaken. In these trials, 3,000 premenopausal and postmenopausal women received postmastectomy radiation and adjuvant systemic therapy, or systemic adjuvant therapy alone. Strikingly, during the 10-year follow-up period, the women who received systemic adjuvant therapy alone were four times more likely to develop local recurrences than the women who received combined therapy.