Approximately two-thirds of women in the United States with stage 1 breast cancer who are 70 years or older, undergo lumpectomy and are eligible to safely omit subsequent radiation therapy (RT) according to national guidelines still receive this type of treatment, according to a study published in the Journal of the American College of Surgeons.1
Researchers led by Quyen Chu, MD, MBA, FACS, of the Louisiana State University Health Sciences Center in Shreveport, Louisiana, looked at 205 000 cases of breast cancer nationwide to compare postlumpectomy RT utilization before and after 2004, when treatment recommendations changed for a select group of elderly patients with breast cancer.
The researchers found that RT use decreased only 3% among women for whom the value of treatment was questionable.
“Why are we as a nation mostly not following a national guideline on breast cancer treatment?” Chu said. “This guideline applies to a significant proportion of patients. About 30% of new diagnoses of invasive breast cancer are in women 70 [years] and older.”
Chu attributed differences in RT use to poorer access to cancer care rather than better adherence to the guideline, as noted by the lowest RT use being seen in the central southeastern states or in small rural populations.
“Patients often ask a surgeon, do I need this operation?” Chu said. “Maybe it’s time to ask your doctor, do I need radiation treatment for my breast cancer?”
1. American College of Surgeons. Recommendation to omit radiation therapy after lumpectomy is not frequently implemented [news release]. EurekAlert! Web site. http://www.eurekalert.org/pub_releases/2016-01/acos-rto012716.php. Posted January 27, 2016. Accessed January 28, 2016.BRE