Old breast cancer treatments are best

A 100-year-old treatment for breast cancer increases long-term survival for some pre-menopausal women with the disease, according to new research which suggests that doctors and patients may want to reconsider this outmoded therapy.

Scientists have shown that "switching off" the ovaries in younger women who have early (operable) breast cancer can save substantially more lives than if they are left functioning.

The finding adds to the growing evidence that hormonal manipulation of early breast cancer may be effective in pre-menopausal women. Until recently, the focus has been on chemotherapy following surgical removal of the tumour in younger women, and hormonal treatment was believed to be much less effective than in post-menopausal women.

However, scientists have found that for every 100 pre-menopausal women with cancer that had not spread beyond the breast and whose ovaries are stopped functioning (known as ablation) by surgery or radiotherapy, an extra six would be alive 15 years later compared with those whose ovaries are left untouched.

In women whose disease had spread to the lymph glands there were an extra 12 survivors per 100 treated in the ovarian ablation group over 15 years.

Dr Mike Clarke, a senior scientist at the Imperial Cancer Research Fund's clinical trials service unit in Oxford, who led the study, said yesterday that it was the first "clear evidence" that ovarian ablation works.

The researchers analysed the results of more than 2,000 women under 50 with operable breast cancer. According to the report in tomorrow's issue of The Lancet, more than 52 per cent of women who underwent ablation were alive 15 years after treatment compared with 46 per cent of those who did not undergo the treatment.

Dr Clarke said the technique was not in routine use and the Department of Health was unable to say how many women with breast cancer undergo ablation each year, but it was not widespread.

Further research is needed to determine if ovarian ablation is of value used in conjunction with chemotherapy or radiotherapy, or prolonged use of anti-oestrogen drugs such as tamoxifen.

Dr Clarke said: "It is important to obtain this new information ... Meanwhile we can say with certainty that where adjuvant therapy for early breast cancer is not routinely used, the value of ablation following breast surgery is substantial and persistent."