Women with early- stage breast cancer who have had
breast conserving surgery (
lumpectomy) followed by
radiation
therapy are
no more likely to develop a second cancer than women who have had a
mastectomy (breast removal), according
to a large study published in the Journal of Clinical
Oncology. This study confirms previous findings and should
help eliminate worries that radiation therapy may increase the
chances of developing a second cancer later in life.
In
the study, Yale researchers analyzed data from over 2000 breast
cancer patients who underwent breast cancer treatment between 1970
and 1990. They found that the risk of developing another
breast tumor was approximately the same for all women (about 10%
after 15 years), regardless of whether they had a mastectomy without
radiation or a lumpectomy followed by radiation. The risk of
developing cancerous tumors elsewhere in the body (such as the
lungs) was also the same among the two groups of women.
The researchers did see an increased risk for a second cancer
(most often, lung cancer) in women who continued to smoke during
treatment. The study also found a slight decrease in the risk
for breast cancer in women who also used hormone therapy (such as
the drug,
tamoxifen), although the researchers
say the difference observed in their study was not large enough to
be statistically significant. However, other large studies
from the
National Surgical Adjuvant
Breast and Bowel Project
(NSABP) have
shown that tamoxifen does reduce the chances of
breast cancer
recurrence .
Interestingly, researchers also found that
chemotherapy after a lumpectomy did not increase the risk for a second
cancer either, compared with mastectomy.
| Common Surgical Options for Early Stage
Breast Cancer |
- Mastectomy
- Lumpectomy followed by six
weeks of radiation therapy
|
Note: Each of these options may include lymph node removal
(with either axillary node dissection or sentinel node
biopsy).
Some earlier studies had shown that radiation therapy might
increase the chances of developing breast cancer again years later,
causing some women to choose to have a mastectomy rather than a
lumpectomy followed by radiation. However, researchers say
that those studies involved women who had received an early form of
radiation therapy after lumpectomy. According to Marc Lippman,
MD of Georgetown University’s Lombardi Cancer Center in Washington,
DC, it is possible that lower-dose radiation and larger surgical
margins (amount of cancer-free tissue a surgeon also removes along
with a cancerous breast lump) that are now standard have reduced the
chances of developing a second cancer in women who undergo
radiation.
“With nearly 15 years
median follow-up periods, these data should be reassuring to women who are considering lumpectomy
and radiation therapy as a treatment option,” the researchers wrote
in their report. Several studies have already found that the
survival rate for women who have a
lumpectomy followed by radiation is equal to the survival rate after
a mastectomy.
Often, women diagnosed with early-stage breast cancer have
the option of having a lumpectomy followed by radiation therapy or a
mastectomy. Though one option may be more favorable than the
other depending on a woman’s situation, this study confirms previous
research that shows a lumpectomy with radiation therapy does not
typically increase the chances for cancer later in life.
However, the researchers plan to continue monitoring the women in
the study, warning that a 15 year observation period after breast
cancer treatment may not be a long enough period to conclusively say
that radiation therapy does not increase cancer risk during a
lifetime.
Additional Resources and
References
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