Navigation Links
EBRT reduces risk of subsequent mastectomy in patients with invasive breast cancer
Date:1/29/2014

Fairfax, Va., January 29, 2014 Standard external beam radiation therapy (EBRT) provided a higher breast preservation rate than brachytherapy in women age 66 and older with invasive breast cancer, according to a study published in the February 1, 2014 print edition of the International Journal of Radiation Oncology • Biology • Physics (Red Journal), the official scientific journal of the American Society for Radiation Oncology (ASTRO).

Brachytherapy after lumpectomy is an increasingly popular treatment protocol for breast cancer; however, there is conflicting data regarding its effectiveness. Additionally, published suitability criteria directing patient selection for brachytherapy have not been empirically validated. This study compares the long-term likelihood of breast preservation, risks of post-operative complications and local toxicities, and validity of suitability categories of three treatment strategies after lumpectomy: EBRT, brachytherapy and no radiation.

This study used the Surveillance, Epidemiology and End Results (SEER)-Medicare linked database to identify 35,947 women, age 66 and older, diagnosed with invasive breast cancer (79.9 percent) or ductal carcinoma in situ (DCIS) (20.1 percent) from 2002 to 2007 and treated with lumpectomy alone (23 percent), lumpectomy followed by brachytherapy (3.6 percent) or lumpectomy followed by EBRT (73.4 percent). Patients with invasive breast cancer were also classified as suitable (34.7 percent), cautionary (17.6 percent) or unsuitable (35.2 percent) for brachytherapy based on ASTRO's Accelerated Partial Breast Irradiation Consensus Statement. Twelve-and-a-half percent of patients were unclassified. The patients with DCIS in this study were analyzed separately. For this study, patients age 70 or older were classified as "older suitable."

The median follow-up for patients was 3.5 years. For this study, subsequent mastectomy is defined as a claim for mastectomy identified from one year after diagnosis until December 31, 2009, which was the last date of follow-up. The five-year cumulative incidence of subsequent mastectomy for patients with invasive breast cancer was 4.7 percent for those treated with lumpectomy alone, 2.8 percent for those treated with lumpectomy followed by brachytherapy and 1.3 percent for those treated with lumpectomy followed by EBRT. In patients with DCIS, 2.2 percent underwent subsequent mastectomy during follow-up. The five-year cumulative incidence of subsequent mastectomy in patients with DCIS was 3.2 percent for those treated with lumpectomy alone, 4.6 percent for those treated with brachytherapy and 1.6 percent for those treated with EBRT.

In this study, brachytherapy was associated with a greater likelihood of breast preservation than lumpectomy alone, while EBRT showed more likelihood of breast preservation than brachytherapy. When stratified into the ASTRO-defined suitability groups, the study found suitable group patients were the least likely to undergo subsequent mastectomy and had the smallest absolute difference when comparing those treated with brachytherapy and those treated with EBRT. The small number of patients with DCIS treated with brachytherapy in this cohort does not allow definitive conclusions on the effectiveness of brachytherapy for these patients.

"Brachytherapy offered a breast preservation benefit, although in general this benefit was slightly less than the benefit derived from standard external beam radiation therapy," said Benjamin D. Smith, MD, a co-author of the study and associate professor in the Department of Radiation Oncology at The University of Texas MD Anderson Cancer Center. "Our findings suggest that certain patients with very favorable tumors do just as well with either brachytherapy or standard external beam radiation therapy, whereas other patients with higher risk tumors seem to do better with standard external beam radiation therapy."

The February 1 print edition of the Red Journal also contains two editorials addressing breast brachytherapy and examining the data from this study. Peter Y. Chen, MD, a radiation oncologist at William Beaumont Health System in Royal Oak, Mich., emphasizes the need to ensure guidelines keep up with changing data. Robert R. Kuske, MD, a radiation oncologist at Arizona Breast Cancer Specialists in Scottsdale, Ariz., and S. Stanley Young, PhD, the assistant director for bioinformatics at the National Institute of Statistical Sciences, explore the reported differences between breast brachytherapy and whole breast irradiation from the statistical and clinical implications.


'/>"/>

Contact: Brittany Ashcroft
press@astro.org
703-839-7336
American Society for Radiation Oncology
Source:Eurekalert

Related medicine news :

1. Exciting New Eye Gel Debuts at Sublime Beauty®: Face Whisperer® Advanced Eye Gel Reduces Dark Circles, Bags and Wrinkles
2. 3-D mammography increases cancer detection and reduces call-back rates, Penn study finds
3. Breast tomosynthesis increases cancer detection and reduces recall rates
4. 3D mammography increases cancer detection and reduces call-back rates, Penn study finds
5. Blocking antioxidants in cancer cells reduces tumor growth in mice
6. Involving patients in their nurses shift change reduces medical errors and satisfies patients
7. North Carolina Municipality Reduces Man Power by Streamlining City Departmental Transaction Processes with Integrated Document Management by Altec
8. New Technology by MinuteHound Reduces Payroll Fraud in Emergency Rooms
9. New study shows spironolactone reduces heart failure hospitalizations, but not mortality
10. Dr. Kathy Gohar Introduces a New Dysport Procedure from Her Spa in Los Angeles That Reduces the Signs of Aging
11. Barnes-Jewish Hospital Research Shows Program Reduces Compassion Fatigue in Caregivers
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:2/12/2016)... , ... February 12, 2016 , ... The law firm ... and Evangeline Parishes. The purpose of these scholarships is to encourage applicants to ... individuals to seek employment within these two parishes. , “We have available jobs ...
(Date:2/12/2016)... ... ... Each year, the American Physical Therapy Association (APTA) offers a Combined Sections ... Center. Almost 10,000 physical therapists across the country are expected to attend this annual ... chosen field and network with their colleagues. As in years past, HydroWorx is ...
(Date:2/12/2016)... ... February 12, 2016 , ... ... (WaaS), today announced the integration of Clarity Intelligence Platform (CIP) into Cielo®, a ... offer real-time business intelligence (BI) to their small and medium business (SMB) clients. ...
(Date:2/12/2016)... ... 2016 , ... Vail knee specialist Robert LaPrade, MD, PhD was ... The list consists of physicians establishing, leading and partnering with ambulatory surgery centers across ... Ambulatory Surgery Center, also known as an ASC, is a modern health care facility ...
(Date:2/12/2016)... ... 2016 , ... For Coast Dental dentist Everet Lake, DDS, the smiles began ... Moore shortly before 7 a.m. to volunteer at Friday’s Dentistry from the Heart event ... skills to help hundreds of uninsured and underinsured people receive much-needed dental care. ...
Breaking Medicine News(10 mins):
(Date:2/11/2016)... -- NOIT™ Research LLC, a private, leading-edge autism research group, ... assist needy families in obtaining one of its special ... 10, 2016 and March 31, 2016, the company will ... is an auditory stimulus that plays a key role ... Beth Shier , NOIT Research director. "The ...
(Date:2/11/2016)... N.C. , Feb. 11, 2016 ... leading provider of custom manufacturing and development services ... expanded sterile fill-finish capabilities and capacity in its ... growth in demand has driven several recent investments. ... 2001 it had one filling line with small-scale ...
(Date:2/11/2016)... Ore. , Feb. 11, 2016 Wellpartner, ... announce the acquisition of SolutionsRx, a full-service 340B company ... Along with providing traditional contract pharmacy services, SolutionsRx also ... clients in navigating the complex 340B regulatory environment. ... --> James R. Love , CEO of ...
Breaking Medicine Technology: