"Moffitt Cancer Center researchers launched a first of its kind study comparing the longterm benefits of radiation therapy in women with breast cancer either before surgery neoadjuvant or after surgery adjuvant. Their study published in the June  issue of Breast Cancer Research found that patients who have neoadjuvant radiation therapy have a significantly lower risk of developing a second primary tumor at any site.  The majority of patients who have early stage breast cancer have surgery to remove their tumor or a complete mastectomy. Surgery is commonly followed by radiation therapy which has been shown to increase relapsefree survival. However in some cases patients may require neoadjuvant radiation therapy to decrease the size of the tumor before surgery. Currently there are no studies that have analyzed the longterm effects of neoadjuvant radiation therapy on breast cancer patients. Moffitt researchers compared the overall survival and the time to diagnosis of a second tumor if any of  breast cancer patients who received either neoadjuvant or adjuvant radiation therapy. They analyzed patient outcomes from a National Cancer Institute NCI registry database of cancer incidence and survival rates in the United States. They included female patients in the analysis who were diagnosed between  and  with earlystage breast cancer. The analysis included  women who received localized neoadjuvant breast radiation therapy before surgery and  women who received localized adjuvant breast radiation therapy after surgery.  The researchers discovered that among the breast cancer patients who tested positive for the estrogen receptor ER biomarker patients who had neoadjuvant radiation therapy had a significantly lower risk of developing a second primary tumor than patients who had adjuvant radiation therapy. This was true for patients who underwent both partial and complete mastectomies. The researchers found that delaying surgery due to neoadjuvant radiation therapy was not a detriment to survival.  A number of recent studies have suggested that radiation therapy may reeducate and stimulate the immune system to target cancer cells. The observed benefit of neoadjuvant radiation therapy aligns with the growing body of literature of the immune activation effects of radiation including shrinking of untreated metastases outside the radiation field explained Heiko Enderling Ph.D. associate member of Moffitts Integrated Mathematical Oncology Department.  These data are promising but randomized clinical trials are needed to confirm the benefit of neoadjuvant radiation therapy. Historic data indicate that diseasefree survival is significantly increased when radiation therapy is applied before surgery rather than after surgery especially for ERpositive patients. These findings are worthy of a prospective clinical trial to confirm potential benefits of neoadjuvant vs. adjuvant radiation and to identify the potential contribution of radiationinduced immunity to vaccinate against future disease said Enderling.  The study was supported by funds received from the American Cancer Society and the DeBartolo Family Personalized Medicine Institute Pilot Research Awards in Personalized Medicine.  About Moffitt Cancer Center  Moffitt is dedicated to one lifesaving mission to contribute to the prevention and cure of cancer. The Tampabased facility is one of only  National Cancer Institutedesignated Comprehensive Cancer Centers a distinction that recognizes Moffitts excellence in research clinical trials prevention and cancer control. Moffitt is the No.  cancer hospital in the nation and has been listed in U.S. News  World Report as one of the Best Hospitals for cancer care since . Moffitt devotes more than . million square feet to research and patient care. Moffitts expert nursing staff is recognized by the American Nurses Credentialing Center with Magnet status its highest distinction. With more than  team members Moffitt has an economic impact in the state of . billion. For more information call MOFFITT  visit MOFFITT.org and follow the momentum on Facebook Twitter and YouTube."