Study suggests some breast cancer patients facing radiation after a mastectomy may be over-treatedSeptember 22, 2008BOSTON -- A new study suggests standard radiation therapy for some breast cancer patients may not be medically required and may, therefore, be causing unnecessary serious side effects such as lymphedema and pulmonary problems. The research conducted at Fox Chase Cancer Center involved women who got a mastectomy, but whose lymph nodes were negative. "When a woman has a tumor greater than 5 centimeters and negative lymph nodes, a mastectomy followed by radiation is recommended," said Penny Anderson, M.D., attending physician in the radiation oncology department at Fox Chase. "We typically irradiate the chest wall because it's been shown to improve survival. Out of an abundance of caution, many radiation oncologists also treat the surrounding lymph nodes, but there is little evidence that this improves outcome." Irradiation of axillary (under arm) and supraclavicular (above the collarbone) lymph nodes can lead to lymphedema, a swelling of the extremities caused by fluid build up because the nodes which allow the fluids to drain have been damaged by radiation. There are also pulmonary radiation risks including pneumonitis, inflammation, scarring and fibrosis. For the study, Anderson and her colleagues evaluated the need for irradiating these lymph nodes in women whose axillary nodal status following surgery was negative. The study included 64 patients with node-negative breast cancer treated by mastectomy and radiation from 1985-2006. Fifty-three patients received radiation therapy to the chest wall only and 11 patients received radiation to the regional lymph nodes in addition to the chest wall. The median follow-up was 78 months. The results were presented at the 50th annual meeting of the American Society for Therapeutic and Radiology Oncology in Boston. "We found an extremely low rate of recurrences in the lymph nodes among those who didn't have them irradiated," said Anderson. In fact, Anderson added, of the 53 patients that received chest wall radiation but no radiation to the lymph nodes, only one developed a recurrence in an axillary lymph node. None of the patients who received chest wall and node radiation had a recurrence. The 5-year overall survival rates for the two groups were 91 percent for group who received radiation to the chest wall and 100 percent for those who also received radiation to their lymph nodes. There was no statistically significant difference noted between the local, regional or distant recurrence rates between the two groups. "Given these findings and the risks of lymphedema and pulmonary toxicity, avoiding irradiating the lymph nodes may be an acceptable approach in select patients," Anderson concludes. Fox Chase Cancer Center |
|||||||||||||||||||||
| Related Mastectomy Current Events and Mastectomy News Articles Plastic surgeons offer microsurgery technique for breast reconstruction, tummy tuck after mastectomy Since her teens, Jennifer Jablon had watched family members deal with breast cancer during their 40s, 50s, and 60s. She wondered whether it would be her fate too. UB Study Explores How Women Make Decisions About Breast Cancer Surgery For women just diagnosed with breast cancer, one of the important decisions confronting them is whether to have a lumpectomy or mastectomy. A diagnosis of breast cancer will affect one in every eight women in the United States. Although more older women receive breast-conserving therapy, gaps in treatment exist According to a new study published in the October issue of the Journal of the American College of Surgeons, although breast-conserving surgery (BCS), commonly known as lumpectomy, is increasingly being used to treat older women with nonmetastatic invasive breast cancer, there are still significant socioeconomic and geographic disparities in the use of this type of therapy. More women choosing to remove healthy breast after cancer diagnosis A new study of New York State data finds that the number of women opting for surgery to remove the healthy breast after a cancer diagnosis in one breast is rising, despite a lack of evidence that the surgery can improve survival. Research needed to learn which DCIS patients may be candidates for less invasive therapy Ductal carcinoma in situ (DCIS), the most common non-invasive lesion of the breast, presents unique challenges for patients and providers largely because the natural course of the untreated disease is not well understood. MRI may be unnecessary prior to treatment in most newly diagnosed breast cancer patients New research findings published in the August issue of the Journal of the American College of Surgeons challenge the routine use of magnetic resonance imaging (MRI) as a means to improve surgical outcomes in newly diagnosed breast cancer patients. MRI may cause more harm than good in newly diagnosed early breast cancer A new review says using magnetic resonance imaging (MRI) before surgery to assess the extent of early breast cancer has not been shown to improve surgical planning, reduce follow-up surgery, or reduce the risk of local recurrences. Women often opt to surgically remove their breasts, ovaries to reduce cancer risk Many women at high risk for breast or ovarian cancer are choosing to undergo surgery as a precautionary measure to decrease their cancer risk. Nerve-block anesthesia can improve surgical recovery, even outcomes When planning for surgery, patients too often don't consider the kind of anesthesia they will receive. In fact, the choice of anesthesia can improve recovery, even outcomes. RI Hospital first in country to enroll patient in new study for recurrent chest wall breast cancer Rhode Island Hospital is one of only four sites across the country to participate in a new clinical trial called the DIGNITY Study. More Mastectomy Current Events and Mastectomy News Articles |
|||||||||||||||||||||
|
|||||||||||||||||||||
|
|||||||||||||||||||||