Researchers at the University of Texas M.D. Anderson Cancer Center released a report last week stating that high-dose chemotherapy (followed by a stem-cell transplant to rebuild the immune system) after surgery may not extend the lives of breast cancer patients. Experts discovered that women who received this aggressive treatment had a few extra cancer-free months, but that they ultimately did not survive any longer than women who never underwent this surgery.

I was surprised by the results. I was expecting some subsets of women to show some survival benefit. Many studies had been suggesting that there were some patients, such as young patients and women with triple negative cancer (cancer cells that lack receptors for estrogen, progesterone or HER2, which makes them difficult to treat with drugs) that would benefit. But our analysis shows that's not true, said Berry. 

The therapy involves multiple steps beginning with the extraction of bone-marrow stem cells from the patient prior to surgery. After the tumor has been removed, the patient is given very high doses of chemotherapy, and then re-infused with their stem cells, which restore immune cells destroyed by the chemotherapy. According to the study, these ultra-high doses of chemo are extremely toxic. Many of the 20,000 women who have received the treatment in the U.S. have died from the toxicity.

The study consisted of 15 trials (6,200 patients) and included women with all types of breast cancer at the beginning stages of disease. Each woman had tested positive for cancer in lymph nodes upon surgery. None of the women in the study had been diagnosed with cancer that had metastasized (spread) to anywhere else in the body.

High-dose chemotherapy was very popular in the 1980s and 1990s when many doctors believed that high doses of chemotherapy was better following cancer surgery. Although it was painful for patients, oncologists believed that high chemo levels would ultimately benefit patients by destroying any cancer cells that could still be in the body.