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Additional, Specialized Radiation not
necessary for some Women after Mastectomy
Newswise — After mastectomy, breast cancer
patients who receive radiation treatment to
the lymph nodes located behind the breast
bone do not live longer than those who do
not receive radiation to this hard-to-treat
area, according to a randomized 10-year
study presented at the plenary session,
November 2, 2009, at the 51st Annual Meeting
of the American Society for Radiation
Oncology (ASTRO).
Breast cancer that is located in an
internal, central location in the breast
area, and larger tumors that have spread to
the lymph nodes located under the arm (axillary)
and just above the collar bone (supraclavicular),
are more likely to spread to the internal
mammary lymph nodes that are located behind
the breast bone.
The type of external beam radiation treament
used to treat these patients is called
internal mammary chain radiation treatment,
or IMC-RT. It is challenging to deliver the
proper dose of radiation to the internal
mammary chain because it is hard to define
its exact location and to protect critical
organs, such as the heart and lung.
“This is the first study that answers the
important question of whether radiation to
the internal mammary chain lymph nodes
benefit these patients after 10 years of
follow-up,” Pascale Romestaing, M.D., lead
author of the study and a radiation
oncologist at Centre de Radiothérapie Mermoz
in Lyon, France said.
“Our findings clearly show that it does not
affect overall survival. These women still
need radiation treatments – just not
additional radiation to these specialized
cells.”
During external beam radiation therapy, a
beam (or multiple beams) of radiation is
directed through the skin to the cancer and
the immediate surrounding area in order to
destroy the main tumor and any nearby cancer
cells. The treatments are outpatient and
generally painless, much like receiving an
X-ray.
The multicenter randomized trial involved
1,334 women newly-diagnosed with stage 1 or
2 breast cancer who had undergone a
mastectomy, or surgery to remove a breast.
Patients had either cancer that had spread
to the axillary lymph nodes or their
original tumor was in an internal, central
location in the breast area. While all
patients received radiation to the chest
wall and supraclavicular lymph nodes,
one-half of the patients were randomized to
also receive the specialized IMC radiation
treatment.
After 10 years, researchers found no
significant differences in survival rates
between the group who received IMC radiation
treatment (63 percent) and those who did not
(60 percent).
The study also found no differences in
survival for patients in the study who were
analyzed in subgroups. These groups included
whether or not their cancer had spread to
their lymph nodes, where their original
tumor was located, and whether they also
underwent chemotherapy or hormone therapy at
the same time they had radiation treatment.
For more information on radiation therapy
for breast cancer, visit
www.rtanswers.org.
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