Navigation Links
Most early-stage breast cancer patients may not need radiation after mastectomy

St. Louis, MO - Breast cancer patients with early stage disease that has spread to only one lymph node may not benefit from radiation after mastectomy, because of the low present-day risk of recurrence following modern surgery and systemic therapy, a finding that could one day change the course of treatment for thousands of women diagnosed each year, according to researchers at The University of Texas M. D. Anderson Cancer.

The research, presented today in the plenary session of the Society of Surgical Oncology Annual Cancer Symposium, showed that stage I and II patients without spread to axillary lymph nodes or with 1-3 lymph nodes with metastasis who received surgery and adjuvant chemotherapy without radiation to the chestwall post-mastectomy had a low overall risk of locoregional recurrences (LRR).

According to Henry Kuerer, M.D., Ph.D., professor and Training Program Director in M. D. Anderson's Department of Surgical Oncology, 90 percent of patients diagnosed with node-positive disease will present with three or fewer nodes. An estimated 47,000 women are diagnosed annually with breast cancer involving 1- 3 lymph nodes. Of those, 30,000 have only one lymph node involvement.

"There is currently no question that radiotherapy after mastectomy is effective at decreasing the chances of LRR and is indicated in breast cancer patients with lymph node spread in greater than four nodes and where the risk of LRR is higher than 10 to 15 percent. However, the need for post-mastectomy radiation in early stage breast cancer patients has been a topic of great debate within the cancer community for decades," explained Kuerer, the study's senior author.

In the 1990s, two landmark randomized trials demonstrated a survival benefit for early stage breast cancer patients with lymph node metastases who received the therapy post-mastectomy, explained Kuerer. Subsequently, in 2005, a meta-analysis of randomized clinical trials that were conducted in the 1960s to 1980s showed both a survival benefit, and a decreased risk of LRR for women with node positive breast cancer. These study findings shifted clinical practice: the National Comprehensive Cancer Network altered their medical guidelines in 2007 to suggest that stage I and II breast cancer patients with one to three lymph node metastases "strongly consider" radiation post-mastectomy.

"We have entered a new era of breast cancer diagnosis and treatment. Modern day advances in all modalities have been dramatic and, collaboratively, have had a significant impact on recurrence and survival. Given these advances, the goal of our study was to assess the present-day LRR risk in women who present with smaller breast tumors and metastases to fewer lymph nodes," said Kuerer.

Kuerer and his colleagues studied clinical and pathological factors from 1,022 stage I or II breast cancer patients who received a mastectomy at M. D. Anderson between 1997 and 2002. Of those women, 79 percent had no lymph node involvement, 26 percent had 1-3 positive lymph nodes, with the majority having just one positive node. None received post-mastectomy radiation and/or pre-operative chemotherapy; 77 percent received post-operative chemotherapy and/or hormonal therapy. The median age was 54 years and the median follow up time was 7.5 years.

The researchers found that there was no statistical difference in the 10-year risk of LRR in women without lymph node spread versus those with spread to one node - 2.1 percent to 3.3 percent, respectively.

The only independent risk factor for LRR was age; patients age 40 and younger, regardless of node involvement, were at significant increased risk for LRR.

"For these younger women, not less, but more treatment may be needed," said Rajna Sharma, M.D., a fellow in M. D. Anderson's Department of Surgical Oncology, who presented the findings.

"For the overwhelming majority of early-stage breast cancer patients treated with modern surgery and systemic therapies, LRR rates may be too low to justify routine use of post-mastectomy radiation," said Kuerer. "This research will provoke much discussion among those caring for women with early-stage breast disease. Replicating these findings should be a priority to ensure that patients only receive therapy that is medically necessary."


Contact: Lindsay Anderson
University of Texas M. D. Anderson Cancer Center

Related medicine news :

1. Researchers find biomarkers in saliva for detection of early-stage pancreatic cancer
2. Ultrasound plus proteomic blood analyses may help physicians diagnose early-stage ovarian cancer
3. Wistar-led research team discovers genetic pattern that indicates early-stage lung cancer
4. Early-stage, HER2-positive breast cancer patients at increased risk of recurrence
5. Genomic Health Announces Data Confirming Manual Microdissection of Biopsy Cavities Is Essential for Accurate Recurrence Risk Assessment in Early-Stage Breast Cancer Patients
6. FDA Clears Hologics MammoSite(R) ML Radiation Therapy System for the Treatment of Early-Stage Breast Cancer
7. Office Ergonomics Book Reveals Early-Stage Solutions
8. Early-stage lung cancer identified using computer-aided system
9. More women with early-stage breast cancer choosing double mastectomies
10. Best Practice Database Adds Research Highlighting the Value of Portfolio Management in Early-Stage Commercialization and Customer-Focused Software Quality Assurance
11. Best Practice Database adds Research Highlighting the Value of Internal Consulting and Early-Stage Commercialization Groups in the Pharmaceutical Industry
Post Your Comments:
Related Image:
Most early-stage breast cancer patients may not need radiation after mastectomy
(Date:11/24/2015)... ... November 24, 2015 , ... Dehydration, defined as a loss ... to perspiration in the hot sun, and heat stroke and death will quickly follow. ... radio host Sharon Kleyne. Every cell, system and structure requires water to function properly. ...
(Date:11/24/2015)... ... 2015 , ... “I am so thrilled, as a newbie here, to leave a mark for ... $7,500 School Lounge Makeover® from California Casualty . Stephanie is in her fifth year ... much longer tenure. , “This is such an amazing school and we deserve a space ...
(Date:11/24/2015)... ... November 24, 2015 , ... ... and safety labels , has been featured in the American Feed ... exclusively to representing the business, legislative and regulatory interests of the U.S. animal ...
(Date:11/24/2015)... ... ... Add a fresh touch to this year’s holiday festivities with indoor plants ... style and cheer to any space. , Holiday plants are more than just festive ... all year long. , “Holiday plants make a room come alive,” says Justin Hancock, ...
(Date:11/24/2015)... ... , ... On the pleasant autumn morning of November 15, 2015, nearly 130 ... for Autism held at Steep Rock Preserve in Washington, Connecticut. The run, which offers ... triumph. , Created and hosted by The Glenholme School, a special needs boarding and ...
Breaking Medicine News(10 mins):
(Date:11/24/2015)... 24, 2015 Teledyne DALSA , a Teledyne ... technology, will introduce its CMOS X-Ray detector for mammography ... 29 to December 3, at McCormick Place in ... diagnostic and interventional imaging will be on display in the ... of advanced CMOS X-Ray detectors is the industry benchmark for ...
(Date:11/24/2015)... , Nov. 24, 2015  Enova Illumination is ... of Helsinki, Finland to combine ... are at the cutting edge of medical visualization: Enova ... the United States and Novocam ... Together, they provide the world,s most powerful battery-operated LED ...
(Date:11/24/2015)... Nov. 24, 2015  Freudenberg Medical has developed specialty tubing ... outside of medical facilities. Africa ... care is sparse. Nevertheless, prompt diagnosis is important to treat ... the virus. With the help of a portable mini-lab or ... to village in affected areas and perform rapid testing for ...
Breaking Medicine Technology: