WEDNESDAY, Oct. 19 (HealthDay News) -- Women with breast cancer
who undergo radiation after a lumpectomy have significantly fewer
recurrences and, consequently, greater odds of survival than women
who forgo radiation, new research says.
The study also noted no long-term adverse effects from radiation
after this breast-conserving surgery, as deaths from any cause were
also reduced substantially.
"For the first time, this showed this important linkage between using radiation to avoid local recurrence and improving long-term survival," said Dr. Jay Harris, chairman of radiation oncology at Dana-Farber Cancer Institute and Brigham & Women's Hospital in Boston. "Up until 2005, the prevailing attitude in the U.S. was that radiation did not have an impact on improving long-term survival and was strictly to reduce local recurrence."
Giving radiotherapy after breast-conserving treatment is already
common practice, said Dr. Shelly Hayes, a radiation oncologist with
Fox Chase Cancer Center in Philadelphia. The point is to destroy
any stray cells in the affected breast.
The findings echo the results of a landmark 2005 paper that
involved fewer women and shorter follow-up. They should help erase
any lingering doubts among skeptics, experts said.
"It is going to be very helpful to see updated results with lots more patients, lots more follow-up and this is very substantial improvement in long-term outcome," Harris said.
Here, the authors assessed data on almost 11,000 women in 17
randomized trials that compared radiation with no radiation after
The authors took the unusual step of including both published
and unpublished trials, making "the data very reliable," said
Overall, irradiating the affected breast halved recurrence rates
and cut the mortality rate by one-sixth, the researchers said.
After 10 years, 19 percent of women who had undergone radiation
had had a recurrence compared with almost twice as many -- 35
percent -- in the non-radiation group.
And 15 years after diagnosis, 25 percent of women with radiation
were alive, vs. 21 percent in the control group. At that time, the
absolute risk reduction in all-cause mortality was 3 percent, the
The numbers varied according to age, grade of tumor,
estrogen-receptor status, whether the patient had taken the
estrogen-suppressing drug tamoxifen and how extensive the surgery
"The magnitude of the benefit got smaller with more favorable factors, but there were benefits in every subgroup, which translated into benefit in terms of recurrence risk, which translated into overall survival," Hayes said.
"Across the board, no matter what those features were, women benefited from radiation," Hayes said.
For some time, doctors have wondered whether radiation was
really necessary for all women, said study co-author Sarah Darby,
professor of medical statistics at the University of Oxford in
"These findings will enable both doctors and patients to have a better idea of the benefit that is likely to be gained from radiotherapy on a patient-by-patient basis," she said.
U.S. National Cancer Institute has more on breast