Some Older Women May Be Able to Skip Radiation After Lumpectomy

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In most cases, the standard treatment for early-stage, hormone-receptor-positive breast cancer is lumpectomy to remove the cancer followed by about 6 weeks of radiation therapy (5 days a week) to destroy any cancer cells that may have been left behind. This two-step approach reduces the risk of breast cancer recurrence (the cancer coming back).

But in 2004, this treatment approach changed for older women. Large studies showed that while lumpectomy plus radiation did reduce the rate of recurrence among older women, it didn’t improve their overall survival. Overall survival is the amount of time the women lived, with or without the cancer coming back. So the National Comprehensive Cancer Network modified its treatment guidelines: radiation therapy became optional for women aged 70 and older diagnosed with early-stage, estrogen-receptor-positive breast cancer who take hormonal therapy for 5 years or more after lumpectomy.

Doctors then wondered if women who were younger than 70 but still postmenopausal also might be able to skip radiation after lumpectomy.

A small study suggests that women aged 55 to 75 diagnosed with early-stage breast cancer treated with only lumpectomy have the same recurrence rates as women treated with lumpectomy and radiation.

The study, “Breast conservation surgery with and without radiotherapy in patients aged 55-75 with early stage breast cancer: A prospective randomized multi-centre trial analysis after 90 months of medium follow-up,” was presented at the 2013 American Society of Breast Surgeons Annual Meeting.

Researchers looked at 749 women aged 55 to 75 who were diagnosed with early-stage breast cancer at 11 medical centers in Italy. The women were randomly assigned to one of two treatment groups:

  • lumpectomy alone
  • lumpectomy followed by radiation therapy

The researchers followed the women for about 9 years.

There was no difference in recurrence rates between the two treatment groups. There was also no difference in overall survival or disease-free survival (the time the women lived without the cancer coming back).

While these results are promising, other research has shown that some older women diagnosed with early-stage breast cancer get benefits from radiation after lumpectomy. More research needs to be done before doctors know for sure which older women can safely skip radiation therapy after lumpectomy to remove early-stage breast cancer.

If you’re a postmenopausal woman and have been diagnosed with early-stage breast cancer, you and your doctor will consider the characteristics of the cancer, your unique situation, your surgical options, your treatment options after surgery, and your personal preferences when creating your treatment plan. If you’ll be having lumpectomy, talk to your doctor about why radiation therapy is or isn’t recommended for you after surgery and how that decision was made.

Using the most complete and accurate information possible, 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 Radiation Therapy section.

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