We
have a group of patients who don’t come along to their doctors,
because they don’t want to be undergoing extensive surgery
at their age. And when they come to you, they’re rather reluctant
patients. They’ve got large operable or locally advanced breast
cancers and they don’t want extensive surgery. They’d
love just to take a pill and go away and forget about it. I think
the potential of giving them neoadjuvant agents like anastrozole
is, there is a high probability if the tumor is estrogen receptor-rich
that that patient will respond and a high probability that at the
end of the period treatment that patient won’t need a mastectomy
and would get away with less extensive treatment and fulfill their
aim and your aim as well.
So
their aim is not to have extensive surgery, which you have managed
to achieve, and your aim is to get rid of the cancer and to achieve
long-term local and systemic control which I believe you can achieve
as well. The patients we’ve treated with neoadjuvant endocrine
treatments have been the happiest group of people in our practice.
They are all remarkably grateful – and like many institutions
we rely on charitable donations – and these people, even though
they are elderly with very little money have been remarkable in
the numbers of charitable donations, because they think it’s
amazing that their large tumors have been shrunk and they just got
away with much less deforming surgery.
