News | October 31, 2012

Radiation After Breast-Conserving Surgery Increases Survival Rate for Older Women

Radiation Therapy Breast Conserving Surgery

October 31, 2012 — Older women with early-stage, low-risk breast cancer who were treated with radiation therapy (RT) after breast-conserving surgery (BCS) showed higher cause- specific (CSS) and overall survival (OS) rates than those who did not undergo radiation, according to research presented at the American Society for Radiation Oncology’s (ASTRO’s) 54th Annual Meeting. The study also found a 6 percent decrease in the use of radiation after 2004 in this population of patients, suggesting that treatment guidelines, which allow for omission of radiation therapy, may need to be re-examined.

The study evaluated the patient records of 27,559 women from the Surveillance, Epidemiology and End Results (SEER) database from 2000 to 2008 who were over the age of 70, who had early-stage (? 5 cm), estrogen receptor positive (ER+), node negative breast cancer and who had completed BCS with a minimum follow-up of three months. Patients who received radiation had a higher OS rate than those who did not, accounting for 87 percent and 73 percent at the five- and eight-year follow-up point, respectively, and 69 percent and 49 percent for those who only underwent BCS. Radiation was also shown to improve CSS rates, which were 97 percent and 95 percent for patients who received radiation at the five- and eight-year follow-up point, compared to 95 percent and 91 percent for those who did not. A total of 4,573 deaths were recorded, 17 percent (790) of which were attributed to breast cancer.

The purpose of the study was to assess changes in patterns of care and to determine CSS and OS outcomes with and without RT after BCS in a large, population-based group of older women. The study separated patients into two groups: BCS or BCS plus RT, and clinical covariates were compared between the groups using the Chi-square test. Cox multivariable regression analyses were performed to determine predictors of CSS and OS. Survival curves were calculated using the Kaplan-Meier method and compared using the log-rank test. Within the study group, 70 percent of patients received RT after BCS. From 2000 to 2004, 72 percent of patients received RT, which decreased to 66 percent from 2005 to 2008. The study found that patients were statistically more likely to undergo RT if they were younger than 80 years old, received a diagnosis from 2000 to 2004 or if re-excision of the biopsy site was required for residual disease.

“Our research shows that older breast cancer patients who undergo radiation therapy after breast-conserving surgery have a higher cause-specific survival rate than those who do not. In practice, however, we also found that the use of breast radiation has declined by 6 percent since the National Comprehensive Cancer Network treatment guidelines were revised in 2005,” said Mariam P. Korah, M.D., lead author of the study and a radiation oncologist at the University of Southern California Keck School of Medicine in Los Angeles. “The large number of patients and breast cancer-specific events in this study highlighted clinically meaningful survival advantages among patients who received radiation in conjunction with breast-conserving surgery as compared to those who received breast-conserving surgery alone, which may not have been detected in earlier studies. In advancing the care of our patients, treatment recommendations should be guided by a synthesis of the best available aggregate evidence.”

The abstract, “Implications of Omitting Radiation after Breast Conserving Surgery in Elderly Women with Low Risk Invasive Breast Cancer,” was presented in detail during a scientific session at ASTRO’s Annual Meeting, on Monday, Oct. 29, 2012.

ASTRO’s 54th Annual Meeting, held in Boston, October 28 – 31, 2012, is the premier scientific meeting in radiation oncology and brings together more than 11,000 attendees including oncologists from all disciplines, medical physicists, dosimetrists, radiation therapists, radiation oncology nurses and nurse practitioners, biologists, physician assistants, practice administrators, industry representatives and other health care professionals from around the world. The theme of the 2012 Annual Meeting is “Advancing Patient Care through Innovation” and examines how innovation in technology and patient care delivery can lead to improved patient outcomes. The four-day scientific meeting includes six plenary papers and 410 oral presentations in 63 oral scientific sessions, and 1,724 posters and 130 digital posters in 18 tracks/topic areas.

For more information:www.astro.org

 

Related Content

Novel Technique May Significantly Reduce Breast Biopsies
News | Breast Biopsy Systems | January 17, 2019
A novel technique that uses mammography to determine the biological tissue composition of a tumor could help reduce...
Digital Mammography Increases Breast Cancer Detection
News | Mammography | January 16, 2019
The shift from film to digital mammography increased the detection of breast cancer by 14 percent overall in the United...
MIM Software Inc. Receives FDA 510(k) Clearance for Molecular Radiotherapy Dosimetry
Technology | Nuclear Imaging | January 16, 2019
MIM Software Inc. received 510(k) clearance from the U.S. Food and Drug Administration (FDA) for molecular radiotherapy...
Artificial Intelligence Used in Clinical Practice to Measure Breast Density
News | Artificial Intelligence | January 15, 2019
An artificial intelligence (AI) algorithm measures breast density at the level of an experienced mammographer,...
Machine Learning Uncovers New Insights Into Human Brain Through fMRI
News | Neuro Imaging | January 11, 2019
An interdisciplinary research team led by scientists from the National University of Singapore (NUS) has successfully...
Sponsored Content | Videos | Breast Imaging | January 11, 2019
Supplemental screening with ABUS helps personalize breast care for women with dense breasts and offers advanced...
Mobile App Data Collection Shows Promise for Population Health Surveys
News | Population Health | January 10, 2019
Mobile app data collection can bring access to more potential clinical study participants, reduce clinical study...
Hypertension With Progressive Cerebral Small Vessel Disease Increases Cognitive Impairment Risk
News | Magnetic Resonance Imaging (MRI) | January 08, 2019
Patients with high blood pressure and progression of periventricular white matter hyperintensities showed signs of...
Artificial Intelligence Pinpoints Nine Different Abnormalities in Head Scans

A brain scan (left) showing an intraparenchymal hemorrhage in left frontal region and a scan (right) of a subarachnoid hemorrhage in the left parietal region. Both conditions were accurately detected by the Qure.ai tool. Image courtesy of Nature Medicine.

News | Artificial Intelligence | January 07, 2019
The rise in the use of computed tomography (CT) scans in U.S. emergency rooms has been a well-documented trend1 in...
Electronic Brachytherapy Effective in Long-Term Study of 1,000 Early-Stage Breast Cancers
News | Brachytherapy Systems, Women's Healthcare | January 07, 2019
Breast cancer recurrence rates of patients treated with intraoperative radiation therapy (IORT) using the Xoft Axxent...