Studies: Radiation Isn't Needed For All Breast Cancer

BOSTON -- Two new studies suggest many older women in the early stages of breast cancer who are taking tamoxifen can skip radiation after having the lump removed.

The findings, published in Thursday's issue of the New England Journal of Medicine, are leading some doctors to say that 40,000 U.S. women a year might be able to skip radiation they would have otherwise gotten. The studies found that they could safely skip it because breast cancer grows so slowly in women over 70.

Radiation has been a standard post-surgical treatment for women having lumpectomies, but the therapy can be inconvenient and unpleasant, with side effects such as pain, swelling, and skin discoloration.

Several studies have shown that, although radiation reduces tumor recurrence, it does not improve overall survival.

"If a patient does not need to have radiation therapy, her quality of life can improve significantly," said Dr. Kevin Hughes, the leader of one of the studies from the Massachusetts General Hospital Cancer Center. "By showing that radiation therapy has very little impact on outcome for these patients, we can help each woman and her physician decide on the right treatment."

But researchers still say most women should still undergo radiation because it helps prevent a relapse.

Hughes' five-year study included more than 600 patients age 70 or older with early stage tumors that had been removed by lumpectomy. The volunteers were randomly assigned to receive either tamoxifen alone or tamoxifen plus radiation.

Both groups had very low rates of recurrence. While those in the tamoxifen-only group had a 4 percent risk, those who also received radiation had an only 1 percent risk. As expected, patients receiving radiation reported more pain, swelling, stiffness and other side effects than did the tamoxifen-only participants.

The other study in the journal, conducted by Canadian researchers, included nearly 800 women over an eight-year period. They found that the rate of recurrence after five years was 7.7 percent in the tamoxifen group and 0.6 percent in the group given tamoxifen plus radiation. But they found no significant differences in overall survival.