Pre-surgery injection may save one lakh breast cancer patients annually, reveals 11-year study

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By Our Special Correspondent

New Delhi, September 12: A study has demonstrated that an injection before surgery on breast cancer patients can make a huge difference.

The study included 1,600 women with early breast cancer who were planned to be treated with surgery. Half of these patients, constituting the control group, received standard surgery followed by standard post-operative treatment, including chemotherapy, hormone therapy and radiotherapy as per guidelines.

The other half, constituting the intervention group, received an injection of a commonly used local anaesthesia agent, 0.5 per cent lidocaine, all around the tumor, just prior to surgery. They then underwent standard surgery followed by the same postoperative treatment as was given in the control group.

Results of the study were contrasting, revealing benefits of administering the injections to the patients.

Dr Rajendra Badwe, Director, Tata Memorial Centre, Mumbai, on Monday presented the results of a landmark multi-centre Indian study on breast cancer.

“The results of this study show that this simple, low-cost intervention significantly and substantially increases the cure rates and survival of breast cancer patients, with a benefit that is ongoing for several years after surgery. The injection requires no additional expertise, is inexpensive, and can result in saving up to 100,000 lives annually globally,” said the Department of Atomic Energy in an official statement.

While the benefits were substantial, the cost less than Rs 100 per patient.

“For comparison, benefits of far lesser magnitude have been achieved in early breast cancer patients by much more expensive, targeted drugs which cost more than Rs 10 lakhs per patient. The trial in women undergoing breast cancer surgery involved the injection of a commonly used drug around the tumour, on the operating table, just prior to surgery,” added the statement.

Dr Badwe presented these findings at the ongoing European Society of Medical Oncology (ESMO) Congress in Paris.

“This is the first study of its kind globally that has shown a sizable benefit by single intervention prior to surgery. If implemented across the world, it has the capability to save over 100,000 lives annually. For scientists, it opens the window of pre-operative intervention to modulate the environment of cancer in such a way as to prevent its deleterious reaction to the act of surgery,” said Dr Badwe.

The study, ‘Effect of Peri-tumoral Infiltration of Local Anaesthetic Prior to Surgery on Survival in Early Breast Cancer’ is a randomized controlled trial, conceived and designed by Dr Badwe, who is the principal investigator. The study was conducted by investigators at 11 cancer centres in India, including Tata Memorial Centre in Mumbai over an 11-year period between 2011 and 2022.

After completion of treatment, patients were followed up regularly for several years to compare the rates of cure and survival between the control group and local anaesthesia group.

When enough follow-up had happened in both groups, the data was analysed at a cut-off date of September 2021.

“As expected, there was no toxicity of lignocaine in patients who received it. The six-year disease-free survival (cure rate) was 81.7 per cent in the control group and 86.1 per cent in the local anaesthesia group for a 26 per cent relative reduction in the risk of cancer relapse or death with the local anaesthesia injection, which was statistically significant,” added the statement.

Similarly, the six-year overall survival was 86.2 per cent versus 89.9 per cent in the two groups for a 29 per cent reduction in the risk of death with the local anaesthetic injection.

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