Navigation Links
RI Hospital researcher: Older women may not benefit from radiotherapy after breast surgery
Date:8/21/2012

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
eslingsby@lifespan.org
401-444-6421
Lifespan
Source:Eurekalert

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:
*Name:
*Comment:
*Email:
(Date:6/26/2016)... North Carolina (PRWEB) , ... June 26, 2016 , ... ... release of a new product that was developed to enhance the health of felines. ... for centuries. , The two main herbs in the PawPaws Cat Kidney Support ...
(Date:6/25/2016)... ... June 25, 2016 , ... Experts from the American ... Annual Research Meeting June 26-28, 2016, at the Hynes Convention Center in Boston. ... including advance care planning, healthcare costs and patient and family engagement. , AIR ...
(Date:6/25/2016)... ... 2016 , ... "With 30 hand-drawn hand gesture animations, FCPX users can easily ... of Pixel Film Studios. , ProHand Cartoon’s package transforms over 1,300 hand-drawn pictures ... . Simply select a ProHand generator and drag it above media or text in ...
(Date:6/25/2016)... Oklahoma (PRWEB) , ... June 25, 2016 , ... ... both athletes and non-athletes recover from injury. Recently, he has implemented orthobiologic procedures ... Oklahoma City area —Johnson is one of the first doctors to perform the ...
(Date:6/24/2016)... Los Angeles, CA (PRWEB) , ... June 24, 2016 , ... ... plastic surgery procedures that most people are unfamiliar with. The article goes on to ... known procedures, but also many of these less common operations such as calf and ...
Breaking Medicine News(10 mins):
(Date:6/26/2016)... -- One of Australia,s successful biotechnology scientists, ... new biotechnology company, Noxopharm Limited [ABN 50 608 966 123] ("Noxopharm"). ... list on the ASX. Noxopharm is a clinic-ready company ... Phase 1 clinical study later this year. ... biggest problems facing cancer patients - the ability of cancers to ...
(Date:6/26/2016)... 2016 Jazz Pharmaceuticals plc (Nasdaq: ... Hart-Scott-Rodino Antitrust Improvements Act of 1976, as amended ("HSR"), ... Inc. ("Celator"; Nasdaq: CPXX ) expired effective ... As previously announced on May 31, 2016, ... agreement under which Jazz Pharmaceuticals has commenced a tender ...
(Date:6/26/2016)... , June 27, 2016  VMS Rehab Systems, ... Board will take whatever measures required to build a ... stock which is currently listed on the OTC Markets-pink ... Company Chairman and CEO, "We are seeing an anomaly ... to understand, not only by the Company, but shareholders ...
Breaking Medicine Technology: