Across the United States only about 6 percent of breast cancer patients are diagnosed with locally advanced breast cancer—about 13,000 women a year. But it is the most common breast cancer diagnosis in many places outside the United States.

It also accounts for nearly one in four breast cancer patients at Jackson Memorial Hospital.

“My research career started because there was a clinical problem that I didn’t know how to solve, so I set about trying to solve it,” says Judith Hurley, M.D., associate professor of clinical medicine at the Miller School of Medicine. “I happened to be in the right place at the right time.”

As early as 1990, Hurley began using platinum-based chemotherapy—which was in use to combat other cancers—to treat breast cancer patients. More recently she has added Herceptin, which is highly effective against a certain subset of breast tumors: those that have a human epidermal growth factor receptor 2, or are “HER2 positive.” Her latest study involved 48 patients and earned an early-release publication in the April Journal of Clinical Oncology.

The five-year, disease-free survival rate for patients with stage III locally advanced breast cancer is between 20 and 50 percent. But Hurley’s patients had an 85 percent survival rate at 43 months. “Seven relapsed, but 41 did not,” says Hurley. “Considering these tumors were an average of 9 centimeters (3 inches) and HER2 over-expressing, you would expect at four years that most of the patients would have relapsed.” The largest tumor in Hurley’s study was 35 centimeters—more than 13 inches.

Dennis Slamon, M.D., Ph.D., chief of the UCLA Oncology Center and the creator of Herceptin, worked with Hurley on the study. Each patient underwent three stages of therapy: a 12-week chemotherapy regimen of docetaxel, cisplatin, and Herceptin to shrink the tumor; surgery to remove the remaining tumor; and then a 12-week chemotherapy regimen of adriamycin and cyclophosphamide.

“These patients do very well, almost as well as patients who had small tumors from the beginning,” says Eli Avisar, M.D., F.A.C.S., assistant professor of surgery and co-leader of the Breast Cancer Disease Group at the University of Miami Sylvester Comprehensive Cancer Center. “The other thing is that if the tumor shrinks significantly, that makes surgery easier and sometimes opens the possibility of sparing the breast and removing only the tumor.”

In fact, one-fourth of the patients had a complete pathological response. They were cured by the chemotherapy.