NSABP Trial Examines Surgery’s Role in Breast Cancer

BUFFALO, NY—The National Surgical Adjuvant Breast and Bowel Project (NSABP) is currently conducting follow-up for a trial that may change the course of breast cancer treatment. The aim of trial B-18 is to determine whether surgery should remain the dominant treatment for breast cancer or should be considered as adjuvant therapy, Norman Wolmark, MD, said at a surgical oncology symposium, hosted by Roswell Park Cancer Institute. Dr. Wolmark is chair of the NSABP and chair of Human Oncology at Allegheny General Hospital.

Women with breast cancer were randomized to receive either chemotherapy followed by surgery or the traditional route of surgery followed by chemotherapy. The trial accrued 1,523 patients between October 1988 and April 1993.

“Through a series of clinical trials over the past 20 years, the NSABP determined that radical surgery was not needed to treat breast cancer—lumpectomy and radiation worked as well. We are now seeking the answer to the question of whether adjuvant therapy first, to shrink the tumor, will improve survival,” Dr. Wolmark said. “The new focus on chemoprevention with tamoxifen [Nolvadex] also shifts attention away from the importance of surgery in the eradication of breast cancer.”