Additional Therapy after Lumpectomy and Radiation

In a little-noticed but potentially important study, researchers from the University of Texas M.D. Anderson Cancer Center have concluded that some breast cancer patients who have been treated with lumpectomy and radiation therapy may also benefit from additional systemic (system-wide) therapy such as tamoxifen and/or chemotherapy.

Dr. Thomas Buchholz and colleagues suggest this additional therapy may benefit women whose breast cancer has not already spread to their lymph nodes (node negative).

In a preliminary presentation at last year's annual meeting of the American Radium Society in London, and in a detailed study just published in the Journal of Clinical Oncology, the researchers presented their findings on 484 node-negative breast cancer patients; 207 were treated with surgery and radiation alone, 149 were given additional treatment with tamoxifen, and 128 received additional chemotherapy with or without tamoxifen.

After a follow-up period of 5+ years, there were 21 local recurrences of the disease in the women who were treated with lumpectomy and radiation, compared to only 8 local recurrences in the groups of women given additional systemic treatment with tamoxifen and/or chemotherapy. No regional recurrences were detected in any of the women in the study.

Specifically, patients treated with the additional systemic therapy had improved 5-year local control rates-97.5 percent vs. 89.8 percent in the lumpectomy/radiation group. Similarly improved local control rates were seen at 8 years-95.6 percent vs. 85.2 percent.

"Systemic therapy appears to contribute to long-term local control in patients with lymph node-negative breast cancer treated with breast-conservation therapy," they concluded. SOURCES:
82nd Annual Meeting of the American Radium Society, April 1-5, 2000, London, England
Journal of Clinical Oncology, April 15, 2001; 19:2240-2246

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