E-News - May 2023
Alliance Trial In Print


Results From Alliance Study Show Patients with More Than One Tumor in A Single Breast may Not Need a mastectomy

Patients who have multiple tumors in one breast may be able to avoid having a mastectomy if the tumors can be surgically removed while leaving enough breast tissue, according to research led by the Alliance in Clinical Trials in Oncology and Mayo Clinic Comprehensive Cancer Center. Patients would undergo breast-conserving therapy — lumpectomy followed by whole breast radiation therapy rather than mastectomy. The study is published in the Journal of Clinical Oncology.

"I am excited about these findings because it will empower patients and the multidisciplinary care teams caring for patients to be thinking about this option for women who may want to preserve their breast," says Judy Boughey, MD, lead author and breast surgical oncologist, and the W.H. Odell Professor of Individualized Medicine. "Some patients may still prefer or require a mastectomy and that is a perfectly fine approach but being able to provide more patients diagnosed with breast cancer with a choice is a great step forward."

The prospective, single-arm trial looked at data from 204 eligible women over the age of 40 that had two or three separate areas of breast cancer in the same breast and were interested in breast conservation. All patients had a preoperative mammogram and/or ultrasound and all but 15 of the women had a breast MRI. The enrolled women underwent lumpectomy to remove the tumors followed by whole breast radiation with radiation boost to each lumpectomy site. The women were observed for five years for subsequent breast cancer events.

The data after five years showed that at a median follow-up of 66.4 months, six patients had a local recurrence - the rate of cancer local recurrence was 3.1%. Dr. Boughey says this is an excellent outcome and is similar to the local recurrence rate for patients with a single tumor in a breast who had breast-conserving therapy.

Historically, women with multiple tumors in one breast have been recommended to undergo a mastectomy. This study will change that by being able to offer this group of patients a less invasive option with faster recovery, resulting in better patient satisfaction as well as cosmetic outcomes, adds Dr. Boughey.

An additional finding is that the local recurrence rate was lower in the patients that had a preoperative MRI, than in the small group of patients that did not have a preoperative MRI (i.e., MRI before surgery). For patients who are considering breast conservation in the setting of two or three tumors in a breast, an MRI prior to surgery should be considered to ensure there is not more extensive disease, Dr. Boughey adds. She also shares that several other factors such as breast size will influence whether a patient would be able to be offered breast-conserving therapy.



This is a phase II clinical trial through the Alliance of Clinical Trials in Oncology, supported by the National Cancer Institute (NCI) through the National Clinical Trials Network. Research reported in this publication was supported by the National Cancer Institute of the National Institutes of Health under Award Numbers U10CA180821 and U10CA180882 (to the Alliance for Clinical Trials in Oncology), UG1CA189869, UG1CA232760, UG1CA233180, UG1CA233290, UG1CA233323, UG1CA233329, and UG1CA233373.