Although one study has given promising results, it's still too early to say if dose-dense chemotherapy is better than standard chemotherapy when treating people with early breast cancer.

Dose-dense chemotherapy is a way of planning treatment so that the drugs are given with less time between treatments than in a standard treatment plan. But the same total dose of chemotherapy is given. For example, if a standard chemotherapy for breast cancer was 8 treatments over 24 weeks (treatment every 3 weeks), a dose dense treatment might give 8 treatments over 16 weeks (treatment every 2 weeks).

There have been a number of studies looking at whether dose-dense therapy improves the effectiveness of chemotherapy when it is given after surgery for early breast cancer. Some of these haven't shown any benefit. But, in one large study involving over 2000 women in the US, researchers showed a small additional benefit when chemotherapy was given in this way. They also found that the side effects for dose-dense chemotherapy weren’t any worse than for standard chemotherapy.

In the study, researchers found that 4 years after treatment 82% of women who had dose-dense chemotherapy had no signs of the cancer returning compared to 75% of the women who had standard chemotherapy. This is a 28% relative reduction in risk of the disease coming back after 4 years in favour of dose-dense therapy. Women who had a type of breast cancer not sensitive to oestrogen (ER negative breast cancer) seemed to be most likely to benefit. Their relative risk reduction from dose-dense chemotherapy was 32% compared to 19% in women with oestrogen sensitive (ER positive) breast cancer.

But, not all studies have found a benefit for dose-dense chemotherapy. So it is too soon to know whether giving chemotherapy in this way really is better than existing treatments.

Researchers in the study have recommended that further studies need to be carried out. The TACT2 trial in the UK is currently looking into the possible benefits of dose-dense chemotherapy for breast cancer.

Reference

• Citron M et al Journal of Clinical Oncology 2003 21: 1431-1439 Randomized Trial of Dose-Dense Versus Conventionally Scheduled and Sequential Versus Concurrent Combination Chemotherapy as Postoperative Adjuvant Treatment of Node-Positive Primary Breast Cancer: First Report of Intergroup Trial C9741/Cancer and Leukemia Group B Trial 9741.