Radiotherapy after mastectomy could benefit more women with breast cancer
“This study suggests that more women than previously thought could potentially benefit from radiotherapy following a mastectomy" - Martin Ledwick, Cancer Research UK
Current NHS guidelines say that women should be offered radiotherapy if their breast cancer has spread to four or more under arm lymph nodes.
But the new study, funded by Cancer Research UK, shows that radiotherapy may also improve survival for women whose cancer has spread to between one and three lymph nodes, and also help prevent their disease from returning.
Until now, there has been uncertainty over the benefits of radiotherapy in these women, said Dr Paul McGale, senior statistician at the Clinical Trial Service Unit in Oxford and an author on the study.
Publishing their findings in The Lancet, the researchers analysed results from 3,786 women from 14 trials conducted over 18 years.
The women had undergone mastectomy and surgical removal of lymph nodes under their arms. They then received either radiotherapy treatment after surgery or not.
The rate of recurrence in women with one to three affected lymph nodes was cut by a third (32 per cent) by radiotherapy, while the death rate fell by a fifth (20 per cent).
Radiotherapy treatment led to nearly 12 fewer recurrences of breast cancer per 100 women after 10 years, and eight fewer deaths per 100 women after 20 years.
The effects in women with only a single affected node were similar to those for women who had two or three affected nodes.
The benefit was also seen regardless of whether or not the women had received chemotherapy or hormonal therapy for their breast cancer.
“This is important because most women today receive these therapies. Our results suggest that women being treated today are likely also to benefit from radiotherapy if they have any positive lymph nodes,” Dr McGale said.
For the 1,772 women with four or more positive nodes, radiotherapy cut recurrences by 21 per cent and deaths by 13 per cent.
Martin Ledwick, Cancer Research UK’s head information nurse, said: “This study suggests that more women than previously thought could potentially benefit from radiotherapy following a mastectomy.
"Radiotherapy is becoming more sophisticated, and 40 per cent of cancer patients who are cured now receive it as part of their treatment.”
The study was funded by Cancer Research UK, the British Heart Foundation, and the UK Medical Research Council
Copyright Press Association 2014
- EBCTCG (Early Breast Cancer Trialists’ Collaborative Group). (2014). Effect of radiotherapy after mastectomy and axillary surgery on 10-year recurrence and 20-year breast cancer mortality: meta-analysis of individual patient data for 8135 women in 22 randomised trials, The Lancet, DOI: 10.1016/S0140-6736(14)60488-8