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Elizabeth Edwards: New Approach in Breast Cancer Treatment

Elizabeth Edwards will undergo 16 weeks of chemotherapy before surgery to remove her breast cancer, according to a new report.

Edwards talked about her aggressive breast cancer treatment plan in an interview to be published in Friday’s issue of People magazine.

In the interview, the wife of the former Democratic vice presidential candidate says she’ll have chemotherapy (search) followed by surgery and then radiation at a Washington area hospital. But she says her prognosis is good.

New Trend in Breast Cancer Treatment

Experts say Edwards’ breast cancer treatment plan reflects a growing trend to use chemotherapy first, rather than after surgery.

The traditional sequence for breast cancer treatment has been surgery to remove the tumor followed by chemotherapy and radiation to eliminate any traces of the cancer and reduce the chances of it coming back.

“What the doctors have proposed for Ms. Edwards is so-called preoperative or neo-adjuvant chemotherapy (search). That is, to flip the usual sequence around so the chemotherapy is delivered first, followed by surgery, followed by radiation, and if appropriate followed by hormone therapy,” says Harold Burstein, MD, PhD, assistant professor of medicine at Harvard Medical School in Boston.

Burstein says studies have shown that the long-term results of either treatment schedule are similar in terms of survival.

“The advantage of giving preoperative chemotherapy is that it can sometimes make for better surgical options,” says Burstein, who also serves as an expert on WebMD’s cancer message board.

For example, in a woman with a large tumor who might normally require a mastectomy (search) (surgical removal of the entire breast), shrinking the tumor with chemotherapy first may allow the surgeon to perform a lumpectomy (search) or removal of only part of the breast.

He says there is also a trend towards using chemotherapy first in breast cancer treatment in order to allow doctors to monitor how the tumor responds to therapy, which might help direct future treatment decisions.

Edwards Missed Annual Mammogram

Edwards was diagnosed on Nov. 3 with invasive ductal carcinoma (search), which is the most common type of breast cancer. In the interview, she says there is no history of breast cancer in her family, but she admits that she had not had a mammogram (search) for four years prior to her diagnosis.

Annual mammograms are recommended for all women over the age of 40. Edwards is 55.

Burstein says it’s impossible to know whether or not having an annual mammogram would have made any difference to Edwards’ prognosis or course of treatment. But he says Edwards is one of many women who fail to follow with these recommendations.

“We know even in places like Massachusetts, where there is excellent access to mammography, that large numbers of women do not comply with the standard National Cancer Institute or American Cancer Society guidelines, and this is something that all women should have access to on a regular schedule,” Burstein tells WebMD.

By Jennifer Warner, reviewed by Brunilda Nazario, MD

SOURCES: Harold J. Burstein, MD, PhD, assistant professor of medicine, Harvard Medical School, Boston.Wire reports. CBSNews.com