Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Majority of older, early-stage breast cancer patients benefit from radiation after lumpectomy

13.08.2012
Findings contrary to current treatment guidelines

For the majority of 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, are contrary to 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 -- and forgo radiation therapy post-surgery.

The potential benefit of radiation in this patient population has been the focus of much research over the past decade, said Benjamin Smith, M.D., assistant professor in the Department of Radiation Therapy at MD Anderson and the study's corresponding author.

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, said Smith. Based on these findings, the NCCN adjusted its treatment guidelines, and radiation therapy following lumpectomy was no longer recommended. Smith then followed up this guideline-changing research with a population-based study, confirming the earlier findings with respect to breast cancer recurrence.

"The motivation for this new research was to do a similarly designed study with longer term follow up," said Smith. "We wanted to do a 10-year update, focusing specifically on the mastectomy question. The fundamental reason it was determined that women didn't need radiation was because the additional therapy did not change mastectomy rates."

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 (SEER) registry who would have been eligible for the 2004 study. 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 the 7,403 women, 88 percent received radiation after their lumpectomy.

Within 10 years of their treatment, 6.3 percent of the women who did not receive radiation therapy had a mastectomy, likely because of a breast cancer recurrence, says Smith, compared to 3.2 percent who had the additional treatment. In patients with high-grade tumors, regardless of other factors such as age and/or tumor characteristics, radiation seemed to be highly beneficial.

The researchers also found a subset of women for whom radiation did not benefit, and thus could be omitted from care regimen: those 75- 79 years of age who had their lymph nodes assessed and did not have high-grade tumors.

"I think the national guidelines, while well intended and important, may gloss over the certain nuances needed for making critical decisions with patients," said Smith. "Our study may shed additional light on some of those nuances and provides data that physicians can use when talking to their patients about whether to go forward with radiation. Personally, having this data point, together with the previous findings, gives me the confidence to not routinely recommend radiation in women age 75 and over with non-high grade tumors."

In addition to Smith, other MD Anderson authors on the study include: Thomas A Buchholz, M.D., professor and head of the Division of Radiation Oncology; Sharon Giordano, M.D., associate professor, Department of Breast Medical Oncology; Jeffrey M. Albert, M.D., resident, Department of Radiation Oncology; and Jing Jiang, Division of Quantitative Sciences. Other authors on the study include: I-Wen Pan, Ph.D. and Ya-Chen Tina Shih, Ph.D., both of The University of Chicago.

The study was funded, in part, by research grants from Varian Medical Systems, U.S. Department of Health and Human Services and the National Cancer Institute. Giordano and Smith are supported by a grant from the Cancer Prevention and Research Institute of Texas. None of the authors declare any conflicts.

Laura Sussman | EurekAlert!
Further information:
http://www.mdanderson.org

More articles from Studies and Analyses:

nachricht Multi-year study finds 'hotspots' of ammonia over world's major agricultural areas
17.03.2017 | University of Maryland

nachricht Diabetes Drug May Improve Bone Fat-induced Defects of Fracture Healing
17.03.2017 | Deutsches Institut für Ernährungsforschung Potsdam-Rehbrücke

All articles from Studies and Analyses >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: A Challenging European Research Project to Develop New Tiny Microscopes

The Institute of Semiconductor Technology and the Institute of Physical and Theoretical Chemistry, both members of the Laboratory for Emerging Nanometrology (LENA), at Technische Universität Braunschweig are partners in a new European research project entitled ChipScope, which aims to develop a completely new and extremely small optical microscope capable of observing the interior of living cells in real time. A consortium of 7 partners from 5 countries will tackle this issue with very ambitious objectives during a four-year research program.

To demonstrate the usefulness of this new scientific tool, at the end of the project the developed chip-sized microscope will be used to observe in real-time...

Im Focus: Giant Magnetic Fields in the Universe

Astronomers from Bonn and Tautenburg in Thuringia (Germany) used the 100-m radio telescope at Effelsberg to observe several galaxy clusters. At the edges of these large accumulations of dark matter, stellar systems (galaxies), hot gas, and charged particles, they found magnetic fields that are exceptionally ordered over distances of many million light years. This makes them the most extended magnetic fields in the universe known so far.

The results will be published on March 22 in the journal „Astronomy & Astrophysics“.

Galaxy clusters are the largest gravitationally bound structures in the universe. With a typical extent of about 10 million light years, i.e. 100 times the...

Im Focus: Tracing down linear ubiquitination

Researchers at the Goethe University Frankfurt, together with partners from the University of Tübingen in Germany and Queen Mary University as well as Francis Crick Institute from London (UK) have developed a novel technology to decipher the secret ubiquitin code.

Ubiquitin is a small protein that can be linked to other cellular proteins, thereby controlling and modulating their functions. The attachment occurs in many...

Im Focus: Perovskite edges can be tuned for optoelectronic performance

Layered 2D material improves efficiency for solar cells and LEDs

In the eternal search for next generation high-efficiency solar cells and LEDs, scientists at Los Alamos National Laboratory and their partners are creating...

Im Focus: Polymer-coated silicon nanosheets as alternative to graphene: A perfect team for nanoelectronics

Silicon nanosheets are thin, two-dimensional layers with exceptional optoelectronic properties very similar to those of graphene. Albeit, the nanosheets are less stable. Now researchers at the Technical University of Munich (TUM) have, for the first time ever, produced a composite material combining silicon nanosheets and a polymer that is both UV-resistant and easy to process. This brings the scientists a significant step closer to industrial applications like flexible displays and photosensors.

Silicon nanosheets are thin, two-dimensional layers with exceptional optoelectronic properties very similar to those of graphene. Albeit, the nanosheets are...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

International Land Use Symposium ILUS 2017: Call for Abstracts and Registration open

20.03.2017 | Event News

CONNECT 2017: International congress on connective tissue

14.03.2017 | Event News

ICTM Conference: Turbine Construction between Big Data and Additive Manufacturing

07.03.2017 | Event News

 
Latest News

Transport of molecular motors into cilia

28.03.2017 | Life Sciences

A novel hybrid UAV that may change the way people operate drones

28.03.2017 | Information Technology

NASA spacecraft investigate clues in radiation belts

28.03.2017 | Physics and Astronomy

VideoLinks
B2B-VideoLinks
More VideoLinks >>>