Thorough breast cancer surgery may make radiation unnecessary
May 13, 1999
Web posted at: 2:37 p.m. EDT (1837 GMT)
(CNN) -- Patients with a common, curable form of breast cancer may be undergoing radiation treatments unnecessarily, according to a study in Thursday's New England Journal of Medicine.
The University of Southern California study of women with "ductal carcinoma in situ (DCIS)," a cancer of the milk glands of the breast, found that among 133 women whose surgeons removed a 10-millimeter margin around the tumor, the chance of the cancer reappearing after eight years was 4 percent.
But when the margin of additional tissue removed was less than 1 millimeter, the risk jumped to 50 percent.
Until 1980, DCIS represented only 1 percent of all newly diagnosed cases of breast cancer. Since then, as mammography has become more widely used and technically better, the number of new cases has increased dramatically to 40 percent.
Up to 80 percent of these patients are eligible for lumpectomy rather than complete breast removal. Opinion is divided on whether radiation therapy is necessary for all DCIS patients who choose lumpectomy.
Oncologist Melvin J. Silverstein and his colleagues, in this study, found that radiation does not appear to benefit patients when at least 10 millimeters of flesh surrounding the tumor has been removed.
"Since DCIS is a noninvasive cancer that does not spread (metastasize), complete excision should cure the patient," Silverstein said.
Radiotherapy can cost more than $15,000, according to Silverstein, and can have side effects.
"Radiation therapy, though highly effective, simply cannot compensate for inadequate surgery," the researchers said.
Reuters contributed to this report.
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University of Southern California study
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