10-Year Results Show that Adjuvant Radiation Therapy Prevents Local Relapses but has no Impact on Survival in Patients with Stage I Breast Cancer

The benefit of routine radiation therapy for preventing cancer recurrence in patients with localized breast cancer has been controversial. Patients with stage II or III cancer with lymph node involvement appear to benefit from radiation. The benefit in earlier stage I or mode negative patients is less clear.

Physicians in Sweden performed a clinical study in patients with localized breast cancers less than 20 millimeters and without lymph node metastasis to receive or not receive radiation therapy after limited surgery (segmental resection). This is a different surgical procedure than “lumpectomy” and usually entails the removal of more normal breast tissue.

The local cancer recurrence rate was 8.5% for the group receiving radiation therapy and 24% for patients not receiving radiation therapy. Survival free from local and distant relapses was 83% for the group receiving radiation therapy and 80% for those not receiving radiation therapy. These physicians concluded that sector resection plus radiotherapy resulted in an absolute reduction in local recurrence of 16% at 10 years compared to surgery alone but had no effect on distant relapses or survival.

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This study confirms several earlier studies which conclude that radiotherapy to the remaining breast tissue after “lumpectomy” improves local control but has no impact on survival.

(Journal of Clinical Oncology, Vol 17, Issue 8, p 2326, 1999)