For most older, early-stage breast cancer patients, radiation therapy following breast conserving surgery may help prevent the need for a later mastectomy, according to research from The University of Texas MD Anderson Cancer Center. The findings, published in the journal Cancer, contradict current national treatment guidelines, which recommend that older women with early- stage, estrogen-positive disease be treated with lumpectomy followed by estrogen blocker therapy alone, foregoing post-surgical radiation.
For most older, early-stage breast cancer patients, radiation therapy following breast conserving surgery may help prevent the need for a later mastectomy, according to research from The University of Texas MD Anderson Cancer Center. The findings, published in the journal Cancer, contradict current national treatment guidelines, which recommend that older women with early- stage, estrogen-positive disease be treated with lumpectomy followed by estrogen blocker therapy alone, foregoing post-surgical radiation.
In 2004, a major study found that women who received tamoxifen alone, compared to tamoxifen and six weeks of radiation, had a slightly higher incidence of breast cancer recurrence. Yet there was no difference in mastectomy rates or survival among the two cohorts, says Benjamin Smith, MD, the study's corresponding author. Based on these findings, the National Comprehensive Cancer Network adjusted its treatment guidelines, and radiation therapy following lumpectomy was no longer recommended.
Smith and colleagues followed up this research with a population-based study. “We wanted to do a 10-year update, focusing specifically on the mastectomy question.” For the population-based study, Smith and his colleagues derived a cohort of Medicare patients from the National Cancer Institute's Surveillance, Epidemiology and End Results registry. The researchers identified 7,403 patients ages 70-79 treated with a lumpectomy for early-stage estrogen-positive breast cancer. All were diagnosed between 1992 and 2002, with follow up through 2007. Of those women, 88% received radiation after their lumpectomy. Within 10 years of treatment, 6.3% of the women who did not receive radiation therapy required a mastectomy, compared to 3.2% who had the additional treatment.
