Many women faced with a breast cancer diagnosis choose mastectomy over lumpectomy believing they can then skip follow-up radiation treatment. “That is not always the case, and patients choosing one surgery over another hoping to avoid radiation need to be aware of this,” says Reshma Jagsi, M.D., of the University of Michigan Comprehensive Cancer Center.
Jagsi (at right above) recently led a study that found many women who undergo mastectomy, in fact, miss this potentially life-saving treatment even when they meet clearly established guidelines that should recommend it. According to BreastCancer.org, these are the guidelines:
- The cancer is 5 centimeters or larger (one lump or a series of lumps together).
- The cancer had invaded the lymph channels and blood vessels in the breast.
- The removed tissue has a positive margin of resection.
- Four or more lymph nodes were involved or, for pre-menopausal women, at least one lymph node was involved.
- The cancer had invaded the skin (with locally advanced or inflammatory breast cancer).
The Web site states that about 20% to 30% of women who have mastectomy fall within these guidelines, and that radiation could help reduce their risk of recurrence by up to 70%.
But when Jagsi and fellow researchers looked at 396 women who had mastectomies, they found that 19% of women who met these guidelines didn’t receive radiation. And the most common reason participants in the study, published online in the journal Cancer and scheduled for the March 15 print edition, said they didn’t choose radiation was that their doctors didn’t recommend it.
The American cancer society says that 184,450 women in the U.S. will be diagnosed with breast cancer this year, and 40,930 will die from the disease.