While radiation therapy is common after breast conserving surgery, it's much less frequent after mastectomy, even among women for whom it would have clear life-saving benefit. This is according to a new study from researchers at the University of Michigan Comprehensive Cancer Center.
The study looked at 2,260 women treated for breast cancer, assessing whether they had lumpectomy or mastectomy, and whether they would be strong candidates for radiation therapy. Women who have particularly large tumors or cancer in four or more of their nearby lymph nodes are recommended to have radiation after mastectomy.
The study found that among patients who should receive radiation therapy according to medical guidelines, 95 percent of those who had lumpectomy went on to receive radiation, but only 78 percent of those who had mastectomy received radiation. Among women for whom radiation is less clearly beneficial, 80 percent of the lumpectomy patients had radiation while only 46 percent of the mastectomy patients did.
"A substantial number of breast cancer patients are being undertreated. One in five women with strong indications for radiation after mastectomy failed to receive it. Radiation can be a life-saving treatment," says study author Reshma Jagsi, M.D., D.Phil, assistant professor of radiation oncology at the U-M Medical School.
The fact that 95 percent of patients who had lumpectomy received radiation in the two metropolitan areas we studied indicates that we can do better than we are currently doing for the selected mastectomy patients who also need radiation. More attention needs to be paid to radiation after mastectomy," Jagsi says.
Results of the study appear online March 29 in the Journal of Clinical Oncology.
The study also found that doctor participation strongly influenced radiation receipt. Patients who reported their surgeon was involved in the decision to receive radiation were more likely to receive radiation than patients whose doctor was less involved.
"Even patients who wanted to avoid radiation therapy were very likely to receive it if their surgeons were highly involved in the decision process. We need to do a better job of educating both patients and physicians regarding the benefits of radiation after mastectomy in certain circumstances, and we need to encourage physicians to help their patients as they make these important decisions," Jagsi says.
In patients with strong indications for radiation after mastectomy, their risk of the cancer coming back in the chest wall or surrounding areas can exceed 30 percent. This is reduced by two-thirds if the patient undergoes radiation treatments, and overall survival is improved.
Methodology: The researchers surveyed 2,260 women in the Los Angeles and Detroit metropolitan areas who had been diagnosed with breast cancer between 2005 to 2007. Women were identified through the Surveillance Epidemiology and End Results registry. Participants were asked about their breast cancer diagnosis and treatment, including whether they received radiation therapy.
Breast cancer statistics: 194,280 Americans will be diagnosed with breast cancer this year and 40,610 will die from the disease, according to the American Cancer Society
Additional authors: Paul Abrahamse, M.A., Sarah T. Hawley, Ph.D., M.P.H., Jennifer J. Griggs, M.D., M.P.H., and Steven J. Katz, M.D., M.P.H., all U-M Comprehensive Cancer Center; Monica Morrow, M.D., Memorial Sloan-Kettering Cancer Center; John J. Graff, Ph.D., M.S., Karmanos Cancer Institute; Ann S. Hamilton, Ph.D., M.A., University of Southern California
Funding: National Cancer Institute, American Cancer Society, California Department of Public Health, Centers for Disease Control and Prevention
Reference: Journal of Clinical Oncology, DOI: 10.1200/JCO.2009.26.8433, published online March 29, 2010Resources:
Nicole Fawcett | EurekAlert!
Smart Data Transformation – Surfing the Big Wave
02.12.2016 | Fraunhofer-Institut für Angewandte Informationstechnik FIT
Climate change could outpace EPA Lake Champlain protections
18.11.2016 | University of Vermont
A multi-institutional research collaboration has created a novel approach for fabricating three-dimensional micro-optics through the shape-defined formation of porous silicon (PSi), with broad impacts in integrated optoelectronics, imaging, and photovoltaics.
Working with colleagues at Stanford and The Dow Chemical Company, researchers at the University of Illinois at Urbana-Champaign fabricated 3-D birefringent...
In experiments with magnetic atoms conducted at extremely low temperatures, scientists have demonstrated a unique phase of matter: The atoms form a new type of quantum liquid or quantum droplet state. These so called quantum droplets may preserve their form in absence of external confinement because of quantum effects. The joint team of experimental physicists from Innsbruck and theoretical physicists from Hannover report on their findings in the journal Physical Review X.
“Our Quantum droplets are in the gas phase but they still drop like a rock,” explains experimental physicist Francesca Ferlaino when talking about the...
The Max Planck Institute for Physics (MPP) is opening up a new research field. A workshop from November 21 - 22, 2016 will mark the start of activities for an innovative axion experiment. Axions are still only purely hypothetical particles. Their detection could solve two fundamental problems in particle physics: What dark matter consists of and why it has not yet been possible to directly observe a CP violation for the strong interaction.
The “MADMAX” project is the MPP’s commitment to axion research. Axions are so far only a theoretical prediction and are difficult to detect: on the one hand,...
Broadband rotational spectroscopy unravels structural reshaping of isolated molecules in the gas phase to accommodate water
In two recent publications in the Journal of Chemical Physics and in the Journal of Physical Chemistry Letters, researchers around Melanie Schnell from the Max...
The efficiency of power electronic systems is not solely dependent on electrical efficiency but also on weight, for example, in mobile systems. When the weight of relevant components and devices in airplanes, for instance, is reduced, fuel savings can be achieved and correspondingly greenhouse gas emissions decreased. New materials and components based on gallium nitride (GaN) can help to reduce weight and increase the efficiency. With these new materials, power electronic switches can be operated at higher switching frequency, resulting in higher power density and lower material costs.
Researchers at the Fraunhofer Institute for Solar Energy Systems ISE together with partners have investigated how these materials can be used to make power...
16.11.2016 | Event News
01.11.2016 | Event News
14.10.2016 | Event News
02.12.2016 | Medical Engineering
02.12.2016 | Agricultural and Forestry Science
02.12.2016 | Physics and Astronomy