Postmastectomy Radiation Recommended To Prevent Recurrence in Certain Early-Stage Cancers

Researchers announced Sunday morning at SABCS that radiation given after chemotherapy and mastectomy seems to prevent local recurrence—the reappearance of cancer in or around the chest wall—in certain patients with early-stage, but aggressive breast cancer.

Data were collected from 162 patients who were given chemotherapy then underwent mastectomy. About three-quarters of patients had received radiation after mastectomy. All patients were diagnosed with node-negative disease (when cancer is not found in the lymph nodes) by either ultrasound or computed tomography. After surgery, patients had a median of 15 lymph nodes removed and more closely examined pathologically for cancer cells. Consequently, about half of patients were found to have positive lymph nodes.

After more than six years follow-up, 15 patients had local recurrence. The five-year local recurrence rate was dramatically higher in the no-radiation group, 24 percent to 4 percent. In patients with pathologically confirmed node-negative disease, risk was 14 percent for those without radiation and 2 percent with radiation, but results were not statistically significant, meaning researchers could not rule out chance for the 12 percent difference.

In patients with node-positive disease, the risk was 53 percent without radiation and 5 percent with radiation. Patients diagnosed with high-grade disease—where the breast cancer cells are determined by a pathologist to be very different from normal breast cells and the disease is considered aggressive—had significantly more local recurrences compared with intermediate/low-grade patients not given postmastectomy radiation.

Researchers concluded that patients who had pathologically confirmed node-positive or high-grade breast cancers would benefit from radiation after mastectomy. However, further studies are needed before recommending radiation in patients with intermediate/low-grade cancers and confirmed lymph node-negative cancers.

Read more of CURE's coverage of the 31st annual San Antonio Breast Cancer Symposium at http://media.curetoday.com/htmlemail/sabcs.