|
| |
| |
Adjuvant RT essential for
breast-conserving surgery patients
|
|
| |
|
|
Radiotherapy (RT) should be included
routinely in the treatment of women with early-stage invasive breast cancer
who undergo breast-conserving surgery (BCS), research published in the
International Journal of Radiation Oncology Biology Physics confirms. While study findings have demonstrated that BCS and adjuvant RT achieve a
similar survival rate to mastectomy in patients with early breast cancer,
the impact of RT on treatment success is unknown. |
|
|
| |
To investigate further, Jennifer Bellon (Dana-Farber Cancer Institute,
Brigham and Women's Hospital, Boston, Massachusetts, USA) and colleagues
examined the outcome of 87 women with unicentric, T1, node-negative,
invasive ductal, mucinous or tubular carcinoma without lymph vessel
invasion.
The patients underwent BCS and achieved a margin of at least 1 cm or a
negative margin on re-excision, but did not receive RT or systemic
treatment.
Following-up the group for a median of 86 months, 23% of patients
experienced local recurrence as first sign of failure, giving an average
annual rate of local recurrence of 3.5 cases per 100 patient-years.
First failure also occurred in the ipsilateral axilla in one patient, as
contralateral breast cancer in two patients, and as distant metastases in
four cases.
Nine patients died during the study, including four deaths from metastatic
breast cancer.
While noting that future risk-assessment profiling may allow the selection
of patients most likely to recur in the absence of RT, the team says that
the risk of local recurrence was "unacceptably high" in their patient group.
"The data do not support the routine omission of RT in healthy women with a
reasonable life expectancy," Bellon et al write, suggesting that
short RT courses or partial-breast RT may be possible in this population.
Nevertheless, they admit: "In women older than 70 years with serious
comorbid illness and a limited life expectancy, however, hormonal therapy
alone is a reasonable option."
Int J Rad Oncol Biol Physics 2006; 65: 1149–1154
http://www.breastcancersource.com/redirecturl.asp? |
| |
|
|
|
