Almost 1 in 5 women who undergo mastectomies after a breast cancer diagnosis are not getting the radiation therapy they need, according to a study to be published in the March 15 issue of the American Cancer Society's journal Cancer. University of Michigan radiation oncologist Dr. Reshma Jagsi and colleagues found that, in a group of breast cancer patients who had undergone mastectomy and whose records clearly indicated that radiation therapy would reduce the risk of a recurrence, 19% failed to get it.
The most common reason women cited for not following their surgery with radiation is that their physicians did not recommend it to them. "That's not good enough," Dr. Jagsi said. "This is clearly lifesaving treatment."
Jagsi suggested that many of the women whose records she studied chose mastectomy over lumpectomy, a somewhat less-disfiguring breast cancer surgery nearly always followed by radiation therapy, because they believed that, with mastectomy, subsequent radiation would not be necessary. "That's not always the case, and patients choosing one surgery over another hoping to avoid radiation need to be aware of this," Jagsi said.
For women with particularly large tumors, or whose cancer has spread to four or more nearby lymph nodes, "there's absolutely no debate" that radiation therapy after surgery is indicated, Jagsi said. In fact, women with lymph node involvement in fewer than four nodes should still consider it, she added.
-- Melissa Healy