June 29th, 2011

Post-Mastectomy Radiation Therapy Underused for High-Risk Breast Cancer


Although post-mastectomy radiation therapy is generally recommended for women with more advanced breast cancers, many of these women do not receive radiation therapy. These results were published in Cancer.

For women who undergo mastectomy (surgical removal of the entire breast) for the treatment of breast cancer, decisions about the need for post-surgery radiation therapy often depend on the extent of the cancer. Clinical trials conducted in the 1990s showed that radiation therapy improves outcomes for women with more advanced cancers, and treatment guidelines generally recommend radiation therapy for these women.

To explore trends in the use of post-mastectomy radiation therapy among women with advanced breast cancers, researchers conducted a study among more than 38,000 women over the age of 65 who were treated with mastectomy between 1992 and 2005. Breast cancer was defined as “high-risk” if it was large or extensive (T3/T4 and/or N2/N3).

  • Among women with high-risk breast cancer, use of radiation therapy after mastectomy increased from 36.5% in 1996 to 57.7% in 1998.
  • There was no further increase in use of post-mastectomy radiation therapy between 1999 and 2005. During 1999-2005, 54.8% of women with high-risk breast cancer received post-mastectomy radiation therapy.

These results indicate that although use of post-mastectomy radiation therapy increased among older, high-risk women after the publication of important clinical trials in the 1990s, radiation therapy may still be underused in these women.

Reference: Shirvani SM, Pan I-W, Buchholz TA et al. Impact of evidence-based clinical guidelines on the adoption of postmastectomy radiation in older women. Cancer. Early online publication June 27, 2011.

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Tags: Breast Cancer, News, Stages II-III Breast Cancer, Uncategorized