Beating the Odds With the Help of Radiation

Radiation after surgery for early-stage breast cancer improves survival chances for most patients, according to a study that analyzed the case histories of more than 9,000 women.

Two doctors evaluated the results of 15 international studies and found that women who omitted radiation therapy after surgery were dying at a rate 8.6% higher than women who had the radiation.

A decision against radiation “may translate into a considerable survival disadvantage for patients,” write Drs. Vincent Vinh-Hung of the Academic Hospital in Jette, Belgium, and Claire Verschraegen of the University of New Mexico’s Cancer Research & Treatment Center in Albuquerque.

A report on the analysis appears this week in the Journal of the National Cancer Institute.

Radiation is given to most early-stage breast cancer patients who choose to undergo a surgical technique, called a lumpectomy, that removes the tumor but leaves the rest of the breast intact, according to an editorial in the journal by Drs. Katherine A. Vallis and Ian F. Tannock of the Princess Margaret Hospital in Toronto.

The findings, they said, reinforce that practice.

All the women in the studies had early-stage breast cancer and underwent breast-conserving surgery. In about half the cases, the patients went on to receive radiation therapy.

Besides improving survival rates, radiation significantly reduced the chance of a relapse of the disease, the study found. The authors found that women who did not undergo radiation were about three times as likely to develop cancer in the previously unaffected breast. The relapse rate was 0.4% to 2.1% per year for women who got radiation and 1.4% to 5.7% per year for women without it.

Despite the statistical survival benefit, however, Verschraegen said radiation is not appropriate for every patient. Some women may have other conditions, such as vascular disease or previous radiation treatments, that make the therapy more risky than the cancer itself.