Life-Saving Benefits of Radiation Not Used Often
After Mastectomy
Breast cancer patients who have mastectomy and need
radiation less likely to receive it than those who have lumpectomy
March
30, 2010 - While radiation therapy is common after breast conserving
surgery, its much less frequent after mastectomy, even among women for
whom it would have clear life-saving benefit. This is according to a new
study from researchers at the University of Michigan Comprehensive
Cancer Center.
The study looked at 2,260 women treated for breast
cancer, assessing whether they had lumpectomy or mastectomy, and whether
they would be strong candidates for radiation therapy. Women who have
particularly large tumors or cancer in four or more of their nearby
lymph nodes are recommended to have radiation after mastectomy.
The study found that among patients who should
receive radiation therapy according to medical guidelines, 95 percent of
those who had lumpectomy went on to receive radiation, but only 78
percent of those who had mastectomy received radiation. Among women for
whom radiation is less clearly beneficial, 80 percent of the lumpectomy
patients had radiation while only 46 percent of the mastectomy patients
did.
A substantial number of breast cancer patients are
being under-treated. One in five women with strong indications for
radiation after mastectomy failed to receive it. Radiation can be a
life-saving treatment, says study author Reshma Jagsi, M.D., D.Phil,
assistant professor of radiation oncology at the
U-M Medical School.
The fact that 95 percent of patients who had
lumpectomy received radiation in the two metropolitan areas we studied
indicates that we can do better than we are currently doing for the
selected mastectomy patients who also need radiation. More attention
needs to be paid to radiation after mastectomy, Jagsi says.
The study also found that doctor participation
strongly influenced radiation receipt. Patients who reported their
surgeon was involved in the decision to receive radiation were more
likely to receive radiation than patients whose doctor was less
involved.
Even patients who wanted to avoid radiation
therapy were very likely to receive it if their surgeons were highly
involved in the decision process. We need to do a better job of
educating both patients and physicians regarding the benefits of
radiation after mastectomy in certain circumstances, and we need to
encourage physicians to help their patients as they make these important
decisions, Jagsi says.
In patients with strong indications for radiation
after mastectomy, their risk of the cancer coming back in the chest wall
or surrounding areas can exceed 30 percent. This is reduced by
two-thirds if the patient undergoes radiation treatments, and overall
survival is improved.
Methodology: The researchers surveyed 2,260 women
in the Los Angeles and Detroit metropolitan areas who had been diagnosed
with breast cancer between 2005 and 2007. Women were identified through
the
Surveillance Epidemiology and End Results registry. Participants
were asked about their breast cancer diagnosis and treatment, including
whether they received radiation therapy.
Breast cancer statistics: 194,280 Americans will be
diagnosed with breast cancer this year and 40,610 will die from the
disease, according to the
American Cancer Society
Additional authors: Paul Abrahamse, M.A., Sarah T.
Hawley, Ph.D., M.P.H., Jennifer J. Griggs, M.D., M.P.H., and Steven J.
Katz, M.D., M.P.H., all U-M Comprehensive Cancer Center; Monica Morrow,
M.D., Memorial Sloan-Kettering Cancer Center; John J. Graff, Ph.D.,
M.S., Karmanos Cancer Institute; Ann S. Hamilton, Ph.D., M.A.,
University of Southern California
March
30, 2010 - While radiation therapy is common after breast conserving
surgery, its much less frequent after mastectomy, even among women for
whom it would have clear life-saving benefit. This is according to a new
study from researchers at the University of Michigan Comprehensive
Cancer Center.
Many women who have battled breast cancer, faced
mastectomy are not aware of breast reconstruction as an option within
their continuum of care