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Value of Radiation Confirmed in Early Breast Cancer
Recurrences Significantly Reduced
Article date: 2003/07/24

A new British study confirms that women with the earliest stage of breast cancer, ductal carcinoma in situ (DCIS), have fewer recurrences if they get radiation therapy after having the cancerous tissue removed. In the United States, most women with DCIS who have a lumpectomy also get radiation. This latest study should reassure women that their radiation treatments are appropriate and effective.

It could also reassure doctors, according to study co-author Joan Houghton, of the UK Coordinating Committee on Cancer Research. "These results are important because many surgeons, especially in the (United Kingdom), think that radiotherapy is not required if the disease is completely removed in surgery," she said in a statement.

DCIS is cancer that is confined to the milk ducts and has not spread into the surrounding breast tissue – although there is a chance it could spread. More cases of DCIS are being detected in the United States thanks to wider use of screening mammography, which can identify this cancer before it becomes large enough to be felt.

New DCIS and Invasive Tumors Prevented

Writing in The Lancet (Vol. 362, No. 9378: 95-102), Houghton and colleagues report the results of a study of about 1,700 women who had lumpectomy for DCIS. Some of the women received no additional treatment after having the cancer removed from their breast, while others got either radiation therapy or tamoxifen, or a combination of the two.

The researchers found that women who got radiation therapy lowered their risk of getting DCIS again in the same breast by more than 60% compared to women who did not receive radiation. The risk of getting invasive cancer in the same breast decreased by more than 50% in women who got radiation compared to those who did not. That translates to one invasive tumor prevented for every 36 women who get a five-week course of radiation, the researchers said.

Radiation did not reduce the risk of getting cancer in the other breast.

Other Studies Also Found Radiation Benefit

This study supports the results of two other large trials that found similar reductions in risk with radiation.

However, the researchers say some questions still remain about which women may be best suited to radiation treatment. They say longer follow-up is needed to determine whether all DCIS patients should get radiation, or whether women at low risk of recurrence can go without.

More research is also needed to determine how tamoxifen may impact disease recurrence in women with DCIS, according to the study authors. In this study, tamoxifen appeared to have little impact on recurrence, regardless of whether the women taking it had gotten radiation or not. The authors say long-term follow-up may clarify how beneficial tamoxifen actually is. They also recommend studies of newer drugs, such as aromatase inhibitors, which have been shown in previous research to be as effective as tamoxifen and possibly even better.


ACS News Center stories are provided as a source of cancer-related news and are not intended to be used as press releases.
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