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Study Questions Guidelines on Radiation for Older Breast Cancer Patients
Date:8/13/2012

By Amanda Gardner
HealthDay Reporter

MONDAY, Aug. 13 (HealthDay News) -- Giving radiation treatment to older women with early-stage breast cancer who have undergone a lumpectomy could lower their risk of needing a mastectomy later on, new research shows.

This suggests that current guidelines recommending that these older patients not have radiation need to be updated, stated the authors of the study, published online Aug. 13 in the journal Cancer.

"Overall in this group of women, radiation was associated with a decrease in mastectomy," said study senior author Dr. Benjamin Smith, an assistant professor of radiation therapy at the University of Texas MD Anderson Cancer Center, in Houston. "The absolute decrease was small but it was certainly measurable."

The current treatment guidelines recommend that older women with early, estrogen receptor-positive breast cancer (a cancer that responds to estrogen) that has not spread to the lymph nodes undergo a lumpectomy to remove the tumor, followed by hormonal therapy but no radiation.

The guidelines were largely based on a 2004 study that concluded that radiation in this group of women only slightly decreased the odds of cancer recurring compared to receiving the estrogen-blocking drug tamoxifen alone.

The risk of a recurrence is very low in older women compared to younger women, for whom radiation following lumpectomy is more routinely recommended.

In the new study, the authors reviewed the medical records of more than 7,400 women aged 70 to 79 who had undergone a lumpectomy for early-stage, estrogen receptor-positive breast cancer between 1992 and 2002.

Almost 90 percent of these women had received radiation after surgery.

After a follow-up period of 10 years, 6.3 percent of women who did not get radiation needed a mastectomy versus only 3.2 percent of women who had received radiation.

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