Women with early stage
breast cancer that has just started to spread are less likely to suffer a
recurrence or die from the disease if they receive radiotherapy after
mastectomy, a new research study has shown.
The study by an
international team of researchers seeks to resolve a debate whether
radiotherapy can help women who have early stage breast cancer that has spread only
to one, two or three of their lymph nodes.
Most breast cancer
treatment guidelines prescribe radiotherapy after mastectomy only to women
whose cancer has spread to four or more lymph nodes --- because studies have
clearly established that adding radiotherapy helps reduce recurrence and
mortality in this set of women. But until now there has not been enough
evidence to recommend radiotherapy to women with limited spread of cancer.
“We’re hoping this new study will influence
clinical practice and help reduce the number of women dying from breast
cancer,” Carolyn Taylor, a clinical oncologist at the University of Oxford and
a member of the research team, told The Telegraph.
The researchers pooled
data from 22 earlier trials mainly in Europe and North America involving 8,135
women with breast cancer with or without spread to their lymph nodes who had
received mastectomy, radiotherapy or chemotherapy or some combinations of
these.
Their analysis, Taylor
said, has shown the benefits of post-mastectomy radiotherapy in both sets of
women — those whose cancer had spread to four or more lymph nodes and those
whose cancer was restricted to one, two or three lymph nodes.
Among 1,314 women who had
cancer in one to three lymph nodes, those who received radiotherapy after
mastectomy had 32 per cent lower recurrence and 20 per cent lower mortality.
Radiotherapy led to 12 fewer recurrences of breast cancer in every 100 women
after 10 years. The results of the study were published today in The Lancet, a
medical journal.
“These are highly significant results,” said
Vinod Raina, a senior oncologist at the Fortis Memorial Research Institute and
Hospital in Gurgaon who had participated in the study’s steering committee
meetings but was not directly involved in it.
While the benefits of
radiotherapy had been established for women with the involvement of four lymph
nodes, Raina said it was not clear whether this strategy also yields similar
benefits to women with smaller number of nodes.
“But over the past four or five years, some
oncology centres have been prescribing radiotherapy to this set of women (with
less than four lymph nodes),” Raina told this newspaper. “These new results
will help consolidate this practice.”
The study observed the
benefits of post-mastectomy radiotherapy regardless of whether the patients in
the trials had or had not received chemotherapy or hormone therapy that is
sometimes part of managing early stage breast cancer.
“By assimilating results from multiple trials,
we’ve reduced the effects of chance and get reliable results,” said Paul
McGale, a senior statistician and team member at the Clinical Trials Research
Unit at the University of Oxford.
The evidence shows that
radiotherapy after mastectomy significantly reduces the risk of recurrence of
breast cancer which, McGale told this newspaper over the telephone, translates
into lower risk of dying from the disease.
Breast cancer has emerged
the most common cancer among women in several Indian cities, including
Bangalore, Calcutta, Chennai, Delhi and Mumbai and the second most malignancy
after cervical cancer in rural areas.
A cancer registry
maintained by the Indian Council of Medical Research suggests that breast
cancer accounts for nearly one-fourth of cancers in women in some Indian
cities.
McGale will present the
results of the study at the European Breast Cancer Conference in the UK on
Thursday.
The 22 trials the study
examined had been initiated between 1964 and 1982. Improvements in radiotherapy
delivery techniques over the past two decades are likely to increase the
proportional benefits to patients. However, improvements in chemotherapy during
the same period could make the absolute gains in reduced risk of recurrence and
mortality appear slightly smaller.
Source:http://www.telegraphindia.com/1140320/jsp/nation/story_18098420.jsp#.UypzMvmSwko
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