According to an article recently published in the International Journal of Radiation Oncology, Biology and Physics, a delay of radiation following a lumpectomy of more than three months may affect survival among women with early breast cancer.

Early breast cancer, or cancer that has not spread from the breast to distant sites in the body, may be treated effectively with a lumpectomy followed by radiation therapy. A lumpectomy is a surgical procedure in which the cancer and a portion of healthy tissue are removed. This is followed by radiation therapy so that undetectable cancer cells that were not surgically removed and may remain near the site of origin are killed.

Radiation therapy may sometimes be delayed due to several factors, including patient inconvenience with travel and clinic time, side effects from surgery and healing from the procedure, additional medical conditions, and various other factors. However, the effect on outcomes of long delays before beginning radiation therapy after a lumpectomy is still being evaluated.

Researchers recently evaluated data from the Surveillance, Epidemiology, and End Results (SEER)-Medicare database to try to identify outcome associations with time intervals between a lumpectomy and initiation of radiation therapy. The data included women aged 65 years or older who were diagnosed between 1991 and 1999 with Stages I–II breast cancer. The patients included in the analysis had not received chemotherapy.

  • 97% of patients received radiation within three months of a lumpectomy.
  • Patients who received radiation after three months following a lumpectomy had a nearly four-fold higher increased risk of death from their disease, and nearly a two-fold higher risk of overall death than patients who received radiation within three months of a lumpectomy.
  • Older age, more advanced stage of cancer, unmarried status, additional medical conditions, and Black race were associated with a greater rate of not receiving radiation therapy within three months of a lumpectomy.

The researchers concluded that although further study is necessary to confirm these findings, it appears that women with early breast cancer should aim undergo radiation therapy within three months following a lumpectomy. Patients with early breast cancer should speak with their physician regarding their individual risks and benefits of scheduling of radiation therapy.

Reference: Hershan D, Wang X, McBride R, et al. Delay in Initiating Adjuvant Radiotherapy Following Breast Conservation Surgery and Its Impact on Survival. International Journal of Radiation Oncology Biology and Physics. 2006; 65: 1353-1360.