Many women who are diagnosed with early stage breast cancer choose a breast-conserving surgical treatment called a lumpectomy. A lumpectomy preserves the majority of the breast by removing only the cancer and surrounding tissue; whereas, a mastectomy involves the complete removal of the affected breast. For most women who decide to have a lumpectomy, it is important for them to receive follow up treatment with radiation therapy in order to reduce the risk of a cancer recurrence.
Breast cancer is a common malignancy occurring in women in the United States, with almost 200,000 new cases diagnosed each year. Breast cancer is characterized by the presence of cancer cells in the tissue or ducts of the breast. Node-negative breast cancer refers to early stage cancer that is confined within the breast with no evidence of spread to nearby lymph nodes.
The National Cancer Institute has adopted a schedule for delivery of radiation over a 5 week period following a lumpectomy. However, radiation therapy is associated with side effects such as fatigue, skin burns, and cosmetic changes. Additionally, patients often need to take time off from work in order to attend radiation treatment sessions. Therefore, clinical studies have been performed to evaluate shorter radiation treatment schedules while maintaining the highest survival benefit for patients.
A study recently completed by researchers of the Hamilton Regional Cancer Centre in Ontario, Canada, evaluated a 3-week radiation schedule for women following a lumpectomy. Over 1,200 women with early stage, node-negative breast cancer received either a 5-week or 3-week schedule of radiation therapy as follow-up treatment after a lumpectomy. Almost 5 years after treatment, there were no comparable differences between the two groups regarding cancer recurrence, cancer-free survival, or overall survival.
These results indicate that a shorter radiation therapy schedule of 3 weeks is as effective as the standard 5-week schedule for follow-up treatment in women who have had a lumpectomy. A shorter schedule could lead to reduced side effects associated with radiation, a more convenient schedule, and a more cost-effective treatment while maintaining optimal treatment effectiveness. However, radiation oncologists in the U.S. will probably continue with the standard 5-week radiation therapy until results from other clinical trials confirm this data.
Women with breast cancer who choose to have a lumpectomy may wish to discuss the risks and benefits of this radiation schedule and/or participation in a clinical trial evaluating other promising new treatments with their physician.
Reference: (Oncology Times, Vol 22, No 6, pp 43-44, 2000)
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