 |
|
Study suggests some breast cancer patients facing radiation after a mastectomy may be over-treated
September 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
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
Mastectomy Current Events and Mastectomy News RSSBreast cancer treatment offers better outcome to women with implants
Women with early-stage breast cancer who have undergone breast augmentation may be treated successfully with a partial-breast radiation treatment called brachytherapy, according to a study presented today at the annual meeting of the Radiological Society of North America (RSNA).
Fear, misconceptions about screenings keep many African-Americans from getting mammograms
Training physicians and caregivers to improve cultural sensitivity and communication with economically disadvantaged African-American patients could influence these women to get mammograms that could save their lives.
Fat injections can improve breast reconstruction -- jury's out on augmentation
Injecting fat after breast reconstruction to correct implant wrinkling or dimpling may be safe and effective to improve breast shape.
Second lumpectomy for breast cancer reduces survival rates
A majority of women with breast cancer today are candidates for lumpectomy, allowing for conservation of most of their breast tissue.
Cancer patients who receive neoadjuvant therapy followed by mastectomy may not need radiation
Early-stage breast cancer patients who exhibit limited lymph node involvement may not require post-surgery radiation therapy (RT) when they receive neoadjuvant chemotherapy before a mastectomy, according to researchers from The University of Texas M. D. Anderson Cancer Center.
Study challenges routine use of MRI scans to evaluate breast cancer
A new study suggests women with newly-diagnosed breast cancer who receive an MRI after their diagnosis face delays in starting treatment and are more likely to receive a mastectomy.
98 percent of elective mastectomy patients would have reconstruction again, says ASPS study
Women who have breast reconstruction after an elective mastectomy are satisfied with their decision, have low complication rates and 98 percent would do it again.
Mastectomies on the rise and MRI use may explain part of the trend, say Mayo researchers
The number of women undergoing mastectomy (total breast removal) for early-stage breast cancer has increased in the last three years at Mayo Clinic in Rochester. The increase follows a steady decline during the prior seven years.
Second breast cancer may be greater than thought for high-risk women without BRCA mutations
A preliminary analysis of ongoing research suggests that high-risk women with breast cancer who do not have a BRCA1/2 mutation may face a greater chance for developing a second breast cancer than previously thought. With the increased risk of cancer in these women, should sentinel node biopsy be considered at the time of prophylactic mastectomy, and how can women best be counseled after these findings?
Breast Reconstruction Advances Fix Distortions Left by Lumpectomy
Lumpectomy or breast conservation surgery is the most common type of breast cancer surgery currently performed. A benefit of the surgery is that only part of the breast is removed, but a drawback can be the resulting physical appearance of the breast, which may be disfigured, dented or uneven.
More Mastectomy Current Events and Mastectomy News Articles
 | Why I Wore Lipstick: To My Mastectomy by Geralyn Lucas NOW A LIFETIME ORIGINAL MOVIE PREMIERING IN OCTOBER!Having recently graduated from Columbia Journalism School and landed her dream job at 20/20, the last thing 27-year-old Geralyn expects to hear is a breast cancer diagnosis. And there is one part of the diagnosis that no one will discuss with her: what it means to be a young girl with cancer in a beauty-obsessed culture. Trying to find herself,... |
 | Mama Said There'd Be Days Like This: A Twelve Step Guide to Surviving a Mastectomy by Karen Klein This book, written by a woman who has undergone breast cancer surgery, presents a series of guiding principles and excercises that can help those who are working to overcome the psychological effects of a mastectomy, as well as those who are just interested in understanding the types of issues and emotions ... |
 | Mammograms and Mastectomies: Facing Them With Humor and Prayer by Susan Farrell Mammograms & Mastectomies is an easy-to-read story filled with practical information and insight into the personal and professional implications of breast cancer. Susan Farrell skillfully combines humor and advice as she covers the challenges of dealing with doctors, learning the language of cancer diagnosis and treatment, formulating the right questions and researching surgical options. She goes... |
 | When Mommy Had A Mastectomy by Nancy Reuben Greenfield How does a mother tell a daughter she has breast cancer? How can a child understand what a mastectomy and reconstruction are all about? When Mommy Had a Mastectomy is a children's book that explains, in a simple and clear manner, why Mommy is sick and what she does after she feels better to return to normalcy. It tells the story of a mother and daughter discovering new ways to show they care... |
| Healing: A Woman's Guide to Recovery After Mastectomy | |
 | After Mastectomy: Healing Physically and Emotionally by Rosalind Benedet This sensitive medical book balances the emotional and biological challenges a woman faces during the post-operation stage of breast cancer by offering wisdom and practical advice. Issues addressed include recovering at home, coping emotionally, and redefining body image. Prosthetics, reconstructive surgery, nutrition, exercise, lymphedema, and follow-up treatment are also... |
| Up Front: Sex and the Post-Mastectomy Woman by Linda Dachman | |
 | The Faces behind Breast Cancer The Faces behind Breast Cancer is an artistic pictorial depicting the courage, strength and dignity of male and female breast cancer patients during all stages of treatment, recovery and remission. The photographs and testimonies represent a diverse, cross-section of cancer survivors and capture the unique essence of each individual's cancer journey with honesty and compassion. The book is... |
| Why I Wore Lipstick to My Mastectomy by Geralyn Lucas | |
 | Pretty Is What Changes: Impossible Choices, The Breast Cancer Gene, and How I Defied My Destiny by Jessica Queller A timely, affecting memoir from the front lines of medical science: When genetics can predict how we may die, how then do we decide how to live?Eleven months after her mother succumbs to cancer, Jessica Queller has herself tested for the BRCA “breast cancer” gene mutation. The results come back positive, putting her at a terrifyingly elevated risk of developing breast cancer before the age of... |
| © 2008 BrightSurf.com |