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19% of
Breast Cancer Patients don’t receive
recommended radiation after Mastectomy
Newswise — One-fifth of women who should receive radiation
after a mastectomy are not getting this
potentially lifesaving treatment, according
to a new study from researchers at the
University of Michigan Comprehensive Cancer
Center.
The study looked at 396 women who were treated with a
mastectomy for breast cancer. The
researchers found that 19 percent of women
who fell clearly within guidelines
recommending radiation treatment after the
mastectomy did not receive that treatment.
Results of the study appear online in the journal Cancer
and will be published in the March 15 issue.
Post-mastectomy radiation is known to decrease the risk of
cancer returning in the chest wall and has
been shown to reduce mortality in high-risk
patients, but there’s been some debate
within the cancer community about who is
likely to benefit most.
Current guidelines recommend radiation after mastectomy for
women who had particularly large tumors or
cancer in four or more of their nearby lymph
nodes.
Even women with fewer positive lymph nodes should strongly
consider radiation treatment.
“There’s an identifiable high-risk group for whom there’s
absolutely no debate -- they need radiation
after their mastectomy. Even in this group
for whom it’s crystal clear, we found that
only four-fifths were treated. That’s not
good enough.
"This is a potentially lifesaving treatment,” says lead
study author Reshma Jagsi, M.D., D.Phil.,
assistant professor of radiation oncology at
the U-M Medical School.
The researchers found that the most common reason women
cited for not considering radiation therapy
was that their doctors did not recommend it.
“Much attention has been focused on educating people that
they need radiation after lumpectomy. But
many women assume having a mastectomy means
radiation won’t be needed.
"That’s not always the case, and patients choosing one
surgery over another hoping to avoid
radiation need to be aware of this,” Jagsi
says.
She adds that doctor-patient communication needs to improve
in this area and that more patients may
benefit from a consultation with a radiation
oncologist.
Improving communications will be a goal of follow-up
research from U-M’s Cancer Surveillance and
Outcomes Research Team, the researchers who
conducted this study.
Breast cancer statistics: 184,450 Americans will be
diagnosed with breast cancer this year and
40,930 will die from the disease, according
to the American Cancer Society
Additional authors: Paul Abrahamse, Jennifer Griggs, M.D.,
M.P.H., and Steven Katz, M.D., M.P.H., all
from U-M Health System; Monica Morrow, M.D.,
from Memorial Sloan-Kettering Cancer Center;
and Kendra Schwartz, M.D., M.S.P.H., from
Wayne State University.
Funding: National Cancer Institute
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