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Pre-menopausal breast cancer patients who undergo mastectomy
(breast removal), followed by chemotherapy, may live longer if
they also receive radiation, according to a recent
study. In the study, 47% of the women who underwent mastectomy, chemotherapy, and
radiation therapy for breast cancer were alive 20 years after treatment, compared with
only 37% who only had mastectomy and chemotherapy alone. Thus, the addition of radiation
therapy appears to increase the chances of long-term survival in young breast cancer
patients who are treated with mastectomy and chemotherapy.
Mastectomy is the surgical removal of a breast. It is a common form of breast cancer
treatment. Most women who are diagnosed with breast cancer undergo some type of surgery as
part of their treatment-either mastectomy or lumpectomy.
During a lumpectomy, only the breast tumor and a surrounding portion of normal breast
tissue are removed. There are several different types of mastectomies. In the current
study, the women underwent modified radical mastectomy, which is the removal of the entire
breast, nipple/areolar region, and often the underarm lymph nodes. This is the most common
form of mastectomy performed today. Breast reconstruction
is usually possible after mastectomy.
Breast cancer surgery is often used in conjunction with other "adjuvant," or
additional, treatments, such as chemotherapy, radiation, or other drugs. Chemotherapy
involves using anticancer drugs to help control or prevent the growth of cancerous tumors.
Chemotherapy is a systemic form of treatment; that is, it is distributed throughout the
bloodstream, affecting tissues and organs in the entire body. Breast cancer patients who
undergo chemotherapy may be given one drug or a combination of two or more drugs during
treatment. Radiation is another form of adjuvant breast cancer treatment. Radiation
therapy uses high-energy rays to stop cancer cells from growing and dividing. It is often
used to destroy any remaining breast cancer cells in the breast, chest wall, or underarm
area after surgery.
Radiation therapy has been shown to reduce the risk that breast cancer will return after
surgical treatment. In the current study, researchers Joseph Ragaz of McGill University
Health Center in Montreal, Canada, and colleagues studied whether radiation could also
increase the chances of survival after breast cancer treatment. The researchers studied
318 women who had been treated with mastectomy and chemotherapy. These women were
considered to have high-risk breast cancer, meaning that there was a high chance that
their breast cancer would return. All of the women were pre-menopausal at the time of
treatment. Of the 318 women, 164 also underwent radiation therapy.
The study results showed that the women who were treated with radiation therapy after
mastectomy and chemotherapy were more likely to be alive 20 years later, compared to those
who did not receive radiation. While studies during the time of these women's treatment
had shown that radiation therapy could cause heart damage in young breast cancer patients,
heart problems were not common in the study. However, the women in the study received a
different type of chemotherapy than is commonly administered today. Therefore, additional
research with newer chemotherapy drugs is needed.
Radiation therapy is associated with a number of side effects, most of which are
temporary. These include:
- fatigue
- neutropenia (reduction in white blood cells)
- breast swelling or tenderness
- feeling of heaviness in the breast
- sunburn-like appearance of the breast skin
- loss of appetite
Breast cancer patients should consult with their cancer treatment teams to determine
the most appropriate treatment for them, given their individual medical situation.
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