Tiny But Aggressive Breast Cancer Tumors

Patients diagnosed early with small tumors can still have aggressive breast cancer. This study was presented at the European Society for Medical Oncology (ESMO) 2017 Congress in Madrid. Researchers found one out of four newly diagnosed breast cancers were aggressive and could benefit from chemotherapy. The study went on to say the aggressive tumors could be identified by a 70 gene signature.

There is a general assumption that smaller tumors are less aggressive, according to the lead author of the study, Dr. Konstantinos Tryfonidis. The MINDACT results, sponsored by the European Organisation for Research and Treatment of Cancer (EORTC), challenge that assumption with statistical research. Researchers analyzed 826 patients, with a primary tumor size less than 1 cm. They found that 196 of those patients were at low clinical risk but high genomic risk.

What does this all mean?

The results challenge a general assumption that most oncologists have been following. If the tumor is small they would generally “watch” it every six months or perform a lumpectomy without chemotherapy. But this new study has found that 24% of those patients actually have an aggressive form of cancer that would benefit from chemotherapy. The study was randomized where half of the patients received chemotherapy and the other half did not.

Dr Fatima Cardoso, Co-Principal Investigator of MINDACT and Director of the Breast Unit of the Champalimaud Clinical Centre, Lisbon, Portugal said they found one in four patients with small tumors are at risk for aggressive breast cancer and would benefit from chemotherapy. Researchers also found that after five years, very few patients who received chemotherapy experienced relapse of their disease. This means survival rates are improving with chemotherapy.

Clearly, not all small breast cancers are the same if 24% of them can metastasize, spreading to other areas of the body. Doctors need to evaluate tumor biology as well as tumor size when deciding on treatment options, said Dr. Evandro de Azambuja, Head of the Medical Support Team, Academic Promoting Team, Jules Bordet Institute, in Brussels, Belgium.

Dr. Evandro de Azambuja went on to comment that all the tumors studied were less than 1 cm and the lymph nodes were free of cancer. This normally is a sign of a good prognosis and not needing chemotherapy; however we now know that one in four of those patients actually have an aggressive form of cancer that would benefit from chemotherapy.

Small node negative tumors can still be aggressive, Dr. de Azambuja went on to say. When determining treatment, doctors need to factor in tumor biology, the patient’s age, overall physical health, emotional health and the patient’s preferences of treatment.

But is this news new? Read on to learn more about this discovery and what this means for breast cancer patients.