Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Radiation after lumpectomy may be unnecessary for many older women

02.09.2004


Tamoxifen alone may adequately control breast cancer, avoiding side effects



Older women treated with tamoxifen after removal of early-stage breast cancer by lumpectomy may safely be able to avoid radiation therapy and its unpleasant side effects. In the Sept. 2 New England Journal of Medicine, investigators from several major cancer research groups report that adding radiation to post-surgical tamoxifen treatment of women age 70 or older does not improve survival, has minimal impact on the risk of local tumor recurrence and does not prevent the need for eventual mastectomy. “If a patient does not need to have radiation therapy, her quality of life can improve significantly,” says Kevin Hughes, MD, of the Massachusetts General Hospital (MGH) Cancer Center, who led the study. “By showing that radiation therapy has very little impact on outcome for these patients, we can help each woman and her physician decide on the right treatment.”

Many breast cancers depend on the hormone estrogen to grow. So tamoxifen, which blocks the interaction between estrogen and its receptor protein, is used to treatment tumors that have that protein on the surface of their cells. Most older breast cancer patients have receptor-positive tumors and receive tamoxifen, a medication that has few side effects.


Radiation has been a standard post-surgical treatment for women having lumpectomies, but the therapy can be both inconvenient and unpleasant, with side effects such as pain, swelling, and skin discoloration. Several studies have shown that, although radiation reduces tumor recurrence, it does not improve overall survival. Because breast cancer is less likely to recur in older women, the research team investigated whether such patients might do well if they receive tamoxifen alone after surgery.

Over a five-year period, more than 600 patients at almost 30 centers across the U.S. enrolled in the study. All the participants were age 70 or older, with early-stage (2 cm or less), receptor-positive tumors that had been removed in lumpectomy procedures. They were randomly assigned to receive either tamoxifen alone or tamoxifen plus radiation as postsurgical treatment.

At the end of the study period, the only significant difference between the groups was in the risk that the tumor would recur at or near its original site. Both groups had very low rates of recurrence; but while those in the tamoxifen-only group had a 4 percent risk, those who also received radiation had an only 1 percent risk. There were no significant differences in terms of distant metastasis, the need for mastectomy after recurrence or overall survival. Both groups had exactly the same number of breast cancer deaths – three in each group, a rate that reflects the less aggressive nature of breast cancer in this age group. As expected, those receiving radiation reported more pain, swelling, stiffness and other side effects than did the tamoxifen-only participants.

“The local recurrence risk in both groups was extremely low, and women who have not had radiation have the option of another lumpectomy if they do have recurrence in the same breast. Once a patient has had radiation, however, she must have a mastectomy if her tumor recurs,” says Hughes, an assistant professor of Surgery at Harvard Medical School. “In the long run, each woman and her physician should choose a treatment plan by weighing the slightly increased local recurrence risk against the virtually certain costs of radiation – the patient’s time, adverse effects, and financial costs.”

Sue McGreevey | EurekAlert!
Further information:
http://www.mgh.harvard.edu

More articles from Materials Sciences:

nachricht A new tool for discovering nanoporous materials
23.05.2017 | Ecole Polytechnique Fédérale de Lausanne

nachricht Did you know that packaging is becoming intelligent through flash systems?
23.05.2017 | Heraeus Noblelight GmbH

All articles from Materials Sciences >>>

The most recent press releases about innovation >>>

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

Im Focus: Can the immune system be boosted against Staphylococcus aureus by delivery of messenger RNA?

Staphylococcus aureus is a feared pathogen (MRSA, multi-resistant S. aureus) due to frequent resistances against many antibiotics, especially in hospital infections. Researchers at the Paul-Ehrlich-Institut have identified immunological processes that prevent a successful immune response directed against the pathogenic agent. The delivery of bacterial proteins with RNA adjuvant or messenger RNA (mRNA) into immune cells allows the re-direction of the immune response towards an active defense against S. aureus. This could be of significant importance for the development of an effective vaccine. PLOS Pathogens has published these research results online on 25 May 2017.

Staphylococcus aureus (S. aureus) is a bacterium that colonizes by far more than half of the skin and the mucosa of adults, usually without causing infections....

Im Focus: A quantum walk of photons

Physicists from the University of Würzburg are capable of generating identical looking single light particles at the push of a button. Two new studies now demonstrate the potential this method holds.

The quantum computer has fuelled the imagination of scientists for decades: It is based on fundamentally different phenomena than a conventional computer....

Im Focus: Turmoil in sluggish electrons’ existence

An international team of physicists has monitored the scattering behaviour of electrons in a non-conducting material in real-time. Their insights could be beneficial for radiotherapy.

We can refer to electrons in non-conducting materials as ‘sluggish’. Typically, they remain fixed in a location, deep inside an atomic composite. It is hence...

Im Focus: Wafer-thin Magnetic Materials Developed for Future Quantum Technologies

Two-dimensional magnetic structures are regarded as a promising material for new types of data storage, since the magnetic properties of individual molecular building blocks can be investigated and modified. For the first time, researchers have now produced a wafer-thin ferrimagnet, in which molecules with different magnetic centers arrange themselves on a gold surface to form a checkerboard pattern. Scientists at the Swiss Nanoscience Institute at the University of Basel and the Paul Scherrer Institute published their findings in the journal Nature Communications.

Ferrimagnets are composed of two centers which are magnetized at different strengths and point in opposing directions. Two-dimensional, quasi-flat ferrimagnets...

Im Focus: World's thinnest hologram paves path to new 3-D world

Nano-hologram paves way for integration of 3-D holography into everyday electronics

An Australian-Chinese research team has created the world's thinnest hologram, paving the way towards the integration of 3D holography into everyday...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Marine Conservation: IASS Contributes to UN Ocean Conference in New York on 5-9 June

24.05.2017 | Event News

AWK Aachen Machine Tool Colloquium 2017: Internet of Production for Agile Enterprises

23.05.2017 | Event News

Dortmund MST Conference presents Individualized Healthcare Solutions with micro and nanotechnology

22.05.2017 | Event News

 
Latest News

How herpesviruses win the footrace against the immune system

26.05.2017 | Life Sciences

Water forms 'spine of hydration' around DNA, group finds

26.05.2017 | Life Sciences

First Juno science results supported by University of Leicester's Jupiter 'forecast'

26.05.2017 | Physics and Astronomy

VideoLinks
B2B-VideoLinks
More VideoLinks >>>