NurseWeek

Boost added to breast cancer battle

By Astara March
Health24News
October 5, 2000


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Washington (H24N). An international trial of more than 5,500 breast cancer patients has found that an extra dose of radiation after lumpectomy can lower the chance of the tumor's coming back by 50 percent.

Women with newly diagnosed breast cancer have two options: a mastectomy, where the whole breast is removed; or lumpectomy, where only the tumor is removed and the remaining breast tissue gets radiation to kill areas of cancer that are too small to see. Both procedures are accompanied by a dissection of the lymph nodes under the arm to see if the cancer has spread. If it has, the patient usually receives chemotherapy.

The new research focused on women who chose lumpectomy. After their surgery and whole breast irradiation, half of the women studied received another smaller dose of radiation, called a boost, to the area of the breast where the tumor had been removed. The other half had no further treatment. Five years after these procedures, 109 (out of more than 2,500) patients who had received the extra radiation had suffered a recurrence, compared to 182 in the group who had no extra treatment reduction of nearly 50 percent. When only patients under age 40 were analyzed, the reduction was 54 percent.

Jean-Claude Horiot, MD, director of the Centre Georges-Francois Leclerc in Dijon, France, reported on the trial to the Second European Breast Cancer Conference, which took place in Brussels Sept. 26-30. Horiot said that the large size of the trial ensured that the findings were reliable, and added, "Patients who had the boost had an overall local control rate of 95 percent, and survival at five years was 91 percent. These impressive results mean that a boost should now be considered the standard treatment for early breast cancer, particularly in younger women."

Because the extra radiation has a negative effect on the way the breast looks after treatment, and is also more costly, Horiot said, "It would not have been acceptable to keep giving a boost dose to patients without evidence of benefit."

The European Organization for Research and Treatment of Cancer (EORTC), based in Brussels, sponsored the trial. It was conducted in 32 medical centers in nine different countries and involved 5,569 patients.