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Most early-stage breast cancer patients may not need radiation after mastectomy
Date:3/6/2010

ducted 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 breas
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Contact: Lindsay Anderson
lindsay.anderson@gabbe.com
212-220-4444
University of Texas M. D. Anderson Cancer Center
Source:Eurekalert  

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