More Women Urged to Get Radiation After Mastectomy
WEDNESDAY, March 31 -- Women who have a mastectomy for breast cancer are less likely to receive follow-up radiation therapy than those who have a lumpectomy, even if the treatment would be potentially lifesaving, a new study has found.
Researchers from the University of Michigan Comprehensive Cancer Center analyzed information on 2,260 Los Angeles and Detroit women with breast cancer, using medical guidelines to assess whether they would be strong candidates for radiation therapy because, for instance, they had particularly large tumors or cancer in four or more nearby lymph nodes.
Among women who they determined should receive radiation therapy, it was given to 78 percent of those who had mastectomy (breast removal) and 95 percent of those who had lumpectomy (removal of the tumor and a small amount of surrounding tissue), the researchers found. Among women who they had determined would not get as much benefit from radiation therapy, the rates were 46 percent for those who'd had a mastectomy and 80 percent for women who'd had a lumpectomy.
"A substantial number of breast cancer patients are being undertreated," Dr. Reshma Jagsi, an assistant professor of radiation oncology at the University of Michigan Medical School and an author of the study, said in a university news release. "One in five women with strong indications for radiation after mastectomy failed to receive it. Radiation can be a lifesaving treatment."
"The fact that 95 percent of patients who had lumpectomy received radiation in the two metropolitan areas we studied indicates that we can do better than we are currently doing for the selected mastectomy patients who also need radiation," Jagsi said. "More attention needs to be paid to radiation after mastectomy."
The researchers found that women were more likely to receive follow-up radiation therapy if their doctors were involved in the decision.
"Even patients who wanted to avoid radiation therapy were very likely to receive it if their surgeons were highly involved in the decision process," Jagsi added. "We need to do a better job of educating both patients and physicians regarding the benefits of radiation after mastectomy in certain circumstances, and we need to encourage physicians to help their patients as they make these important decisions."
A report on the study was published online March 29 in the Journal of Clinical Oncology.
Posted: March 2010