Navigation Links
RI Hospital researcher: Older women may not benefit from radiotherapy after breast surgery

PROVIDENCE, R.I. A Rhode Island Hospital radiation oncologist says in a new editorial that research exploring the impact of radiotherapy in older women with low risk of breast cancer recurrence has little effect on actual clinical decisions. The editorial written by David E. Wazer, M.D., chief of the department of radiation oncology, is published in the current issue of the Journal of Clinical Oncology.

Breast-conserving therapy (BCT) has shown to have comparable outcomes to mastectomy, allowing women to preserve their breast without compromising their chance of being cured of cancer. BCT also has been associated with improved quality of life, as compared to mastectomy. Radiation therapy is an integral part of BCT, and its benefit is clearly dependent on the baseline risk of ipsilateral breast tumor recurrence (IBTR) after surgical excision alone, and is small in patients at low risk of recurrence. Multiple trials have shown that the IBTR risk decreases with age, and has prompted analysis of the benefit of radiotherapy for older patients with breast cancer.

"If an older patient has been treated for breast cancer, and has a low risk of recurrence, there may be no clinical reason to subject them to radiation therapy," Wazer said. "It's simply not necessary -- it will not improve their quality of life, nor increase their chance of survival."

Wazer references the Cancer and Leukemia Group B 9343 trial that demonstrated that radiotherapy has no discernable benefits as measured by either mastectomy free (MFS) or overall survival in a highly selected group of patients age 70 or older with estrogen receptor (ER) positive tumors who received five years of tamoxifen.

Despite evidence to support this finding, a recent Surveillance, Epidemiology and End Results (SEER) Medicare database analysis showed that this data has minimal impact on clinical decisions, suggesting that oncologists perceive meaningful differences between patients treated in routine clinical practice as compared with those enrolled in clinical trials.

"True, there are factors to the SEER-Medicare database analysis that could raise eyebrows," Wazer said. "For example, in the absence of direct data related to the incidence of IBTR, the authors were compelled to use billing codes as surrogates for clinical events, meaning the same mastectomy billing code recorded as indicative of tumor recurrence could be reflective of an entirely unrelated event."

Wazer continued, "But oncologists must look at the big picture. Will the radiation therapy truly help that patient in her 70s who is at a very low risk of tumor recurrence? Not likely. It is perplexing to see that despite high-quality clinical trial evidence supporting the omission of breast radiotherapy in select older patients, the pattern of clinical practice in the United States seem to show little change."

Contact: Ellen Slingsby

Related medicine news :

1. Many Test Results Left Unread as Patients Leave Hospital: Study
2. Weekend hospital stays prove more deadly than other times for older people with head trauma
3. Rhode Island Hospital study: Bariatric patients with obstructive sleep apnea fail to show symptoms
4. Hospital of the University of Pennsylvania selected to lead US nurse-training initiative
5. Killer infections targeted by hospital study
6. Implementing a therapeutic hypothermia program for post-cardiac arrest in acute care hospitals
7. Medical complications in hospitalized children: The Canadian Paediatric Adverse Events Study
8. Burnt-Out Nurses Linked to More Hospital Infections
9. In Massachusetts, individual mandate led to decreased hospital productivity
10. Nurse staffing, burnout linked to hospital infections
11. MRSA cases in academic hospitals double in 5 years: study
Post Your Comments:
(Date:10/13/2017)... ... 2017 , ... Global Healthcare Management’s 4th Annual Kids Fun Run brought out ... free event, sponsored by Global Healthcare Management’s CEO, Jon Letko, is aimed at getting ... children of all ages; it is a non-competitive, non-timed event, which is all about ...
(Date:10/13/2017)... ... 13, 2017 , ... Talented host, actor Rob Lowe, is ... a new episode of "Success Files," which is an award-winning educational program broadcasted ... each subject in-depth with passion and integrity. , Sciatica occurs when the sciatic ...
(Date:10/13/2017)... ... ... “The Journey: From the Mountains to the Mission Field”: the story of a missionary ... Journey: From the Mountains to the Mission Field” is the creation of published author, ... ages and currently teaches a class of ladies at her church, which she has ...
(Date:10/12/2017)... Del. (PRWEB) , ... October 12, 2017 , ... ... and advisory services for healthcare compliance program management, will showcase a range of ... National Association for Assisted Living (NCAL) Convention and Expo to be held October ...
(Date:10/12/2017)... (PRWEB) , ... October 12, 2017 , ... Planet Fitness, ... the U.S., announced today its plans to open a flagship location in Covington, LA ... the former Rooms To Go store next to Office Depot in the Holiday Square ...
Breaking Medicine News(10 mins):
(Date:9/27/2017)... 2017  Commended for their devotion to personalized service, SMP ... number one in the South Florida Business Journal,s 50 Fastest-Growing ... yearly list, the national specialty pharmacy has found its niche.  ... will soon be honored by SFBJ as the 2017 Power ... Set to receive his award in October, Bardisa said of ...
(Date:9/25/2017)... PROVIDENCE, R.I. , Sept. 25, 2017 /PRNewswire/ ... immunogenicity assessment, vaccine design, and immune-engineering today announced ... focused on the development of personalized therapeutic cancer ... and has provided exclusive access to enabling technologies ... MSc Eng., MBA will lead EpiVax Oncology as ...
(Date:9/22/2017)... AVACEN Medical (AVACEN) announced that its CE-Marked ... those with the widespread pain associated with fibromyalgia in ... Essex, England commented, "I had ... no sleep at all, tremendous pain, with every movement ... [the AVACEN 100] enough, how this has and is ...
Breaking Medicine Technology: