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Radiation Therapy After Surgery Less Likely for Young Women

March 29, 2013

Written By Robin Warshaw, Contributing Writer
Reviewed By Jennifer R. Bellon, MD

Young women may not be receiving the most complete local treatment to prevent breast cancer from returning, a recent study found.  

The study, published in Breast Cancer Research and Treatment, examined the rate of adjuvant (following surgery) radiation therapy in women age 40 and under.

Background and Reason for the Study

After surgery, radiation may be used for additional local breast cancer treatment. By focusing high-energy x-rays on the breast area, radiation can destroy remaining cancer cells. This can reduce the risk of breast cancer returning to the same area it originally developed, known as locoregional recurrence.

Earlier research has shown that women diagnosed younger than 35 are more likely to have breast cancer return to the same area than older women with the same disease stage.

Radiation therapy given in early-stage breast cancer after breast-conserving surgery (BCS), or lumpectomy, has been shown to result in the same overall survival as mastectomy without radiation.

Little is known about how frequently young women receive radiation therapy after breast cancer surgery. Researchers from Dana-Farber Cancer Institute, Harvard Medical School and Brigham and Women’s Hospital in Boston, as well as the American Cancer Society, conducted this study to determine if age is associated with receiving adjuvant radiation treatment.

Study Structure

The study used records from a large national cancer registry that included 317,596 women, ages 18 to 64, diagnosed with invasive breast cancer from 2004 to 2008:

  • 11 percent of the women were younger than, or equal to, age 40 when diagnosed
    • 4 percent were age 35 or younger
    • 7 percent were ages 36 to 40

The researchers looked at the use of mastectomy (surgical removal of one or both breasts) compared to:

  • Breast-conserving surgery, without radiation therapy
  • BCS, followed by radiation therapy
  • Postmastectomy radiation (PMRT)

Findings

Compared to older women, those age 40 or younger were significantly more likely to have a mastectomy than receive BCS:

  • 35 or younger—57 percent had mastectomy
  • 36 to 40—52 percent
  • 61 to 64—35 percent

When BCS was the treatment given, younger women were less likely to receive radiation therapy afterward:

  • 35 or younger—69 percent had adjuvant radiation after BCS
  • 36 to 40—73 percent
  • 61 to 64—80 percent

Rates for postmastectomy radiation were low for all groups, but women 40 and under were more likely to receive PMRT than were those ages 61 to 64.

The researchers say their study suggests that young women “may not be receiving optimal locoregional therapy.” More studies are needed to confirm their findings, they concluded, and to understand what barriers keep young women from receiving adjuvant radiation therapy after breast-conserving surgery.

Citing the improvements in disease-free and overall survival that could be provided by such treatment, the researchers stated that radiation therapy should be given to more young women, when appropriate.

What This Means for You

If you are newly diagnosed with breast cancer, discuss your treatment options fully with your healthcare provider. Ask which therapies will help prevent cancer return, and whether having radiation therapy after surgery is appropriate for you.

You may be long past your surgical treatment and feel concerned about your risk of recurrence. Reading about the benefits of adjuvant radiation therapy may worry you if you did not have that treatment. Remember that radiation is not appropriate for every woman affected by breast cancer. Other therapies also can help keep cancer from returning.

Talk with your provider about the therapies you had and how to lower your risk of local recurrence now. You can also speak confidentially with someone who understands what you’re feeling, on our    Breast Cancer Helpline at (888) 753-LBBC (5222).

RAFreedman, KS Virgo, J Labadie et al. Receipt of Locoregional Therapy Among Young Women with Breast CancerBreast Cancer Research and Treatment, 2012 Oct;135(3): 893-906.

This article was supported by Cooperative Agreement Number DP11-1111 from The Centers for Disease Control and Prevention. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention.

Denver, CO  ·  September 13, 2014

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