Women Who Would Benefit May Not be Getting Radiation After Mastectomy

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Almost all women get radiation therapy after lumpectomy. Lumpectomy plus radiation has been shown to be as effective as mastectomy without radiation for many women. Radiation isn't routinely given after mastectomy, but some women do benefit from it. Still, a study found that some women who would benefit from radiation after mastectomy aren't getting radiation.

Doctors sometimes use "T" to talk about the size of a cancer. T1 and T2 breast cancers are smaller and T3 and T4 cancers are larger. Breast cancers that are T3 or T4 and/or have two or more lymph nodes involved may benefit the most from radiation after mastectomy.

The researchers in this study surveyed 2,260 women diagnosed with breast cancer that hadn't spread to parts of the body away from the breast. Of the 1,627 women who filled out the survey, more than 79% had lumpectomy; 93.3% of these women had radiation after lumpectomy. The other 20% of the women had mastectomy and 60.2% of these women had radiation after mastectomy.

Since radiation therapy isn't given routinely after mastectomy, it seems to make sense that 39.8% of the women who had mastectomy didn't get radiation. To see if any women who didn't get radiation after mastectomy might have benefited from it, the researchers looked at how many women diagnosed with cancer likely to respond to radiation actually got radiation. These cancers were classified as "strong indication for radiation."

The researchers expected that nearly all of the "strong indication for radiation" cancers would have been treated with radiation.

  • 95.4% of women who had lumpectomy and cancers classified as "strong indication for radiation" got radiation
  • 77.6% of women who had mastectomy and cancers classified as "strong indication for radiation" got radiation

So it seems that some women who could benefit from radiation therapy after mastectomy aren't getting those benefits.

But if the breast cancer surgeon was very involved in treatment planning, radiation was more likely to be given if indicated. Women who said they really didn't want to have radiation were the most likely not to get radiation.

If you've been diagnosed with breast cancer, you and your doctor will consider the specifics of the cancer, your unique situation, your surgical options, and your treatment options after surgery when creating your treatment plan. If you choose lumpectomy, it's very likely that radiation will be recommended after surgery. If you choose mastectomy, you might want to ask your doctor if you would benefit from radiation, especially if the cancer is large or has spread to more than one lymph node.

Using the most complete and accurate information, you and your doctor can develop a treatment plan that makes the most sense for you. You can learn more about radiation after breast cancer surgery in the Breastcancer.org Radiation Therapy section.

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