Pre-surgery pills may help breast cancer patients

Taking hormone-blocking pills for a few months before breast cancer surgery can shrink tumors and allow many women to have just the lump removed instead of the whole breast, a new study suggests.

This approach is sometimes tried now in Europe, and the study was the first large test of it in the United States. It won't change practice right away; a second study is starting to try to repeat the results and identify which drugs work best.

Ultimately, though, this new approach could affect the care of tens of thousands of women each year with large tumors whose growth is fueled by estrogen. It might give them not just a gentler surgery option, but also may let many of them skip chemotherapy.

Before being treated with the hormone blockers, most of the women in the study were facing likely mastectomies because their tumors were too large for less drastic surgery.

"Half of them wound up having successful breast-conserving therapy," said Dr. John Olson, breast cancer surgery chief at Duke University. "That is a huge deal."

He led the study and gave results in a telephone news conference Wednesday. They will be presented Saturday at a meeting of the American Society of Clinical Oncology and several other groups in Washington. Results also have been sent to a scientific journal and are under review.

Of the more than more than 200,000 breast cancers diagnosed each year in the U.S., about 70 percent have their growth fueled by the hormone estrogen.

The study involved 374 women at more than 100 sites around the country whose tumors were especially sensitive to estrogen. Doctors already know that chemotherapy is less effective in such women, and they wanted to see whether hormone-blocking drugs would work well enough to allow more of these women to be treated without removing their breasts.

Tamoxifen used to be the gold standard hormone blocker, but newer drugs called aromatase inhibitors do the job with fewer side effects.

The women in the study were randomly assigned to get one of three such medicines: Pfizer Inc.'s Aromasin, Novartis' Femara or AstraZeneca PLC's Arimidex. They cost from $340 to $420 a month, although Arimidex is available in generic form and patents on the others expire within a few years.