Studies Evaluate Breast Cancer Outcomes In Older Patients, Women With Breast Augmentations

Main Category: Breast Cancer
Also Included In: Seniors / Aging
Article Date: 03 Dec 2008 - 2:00 PDT

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The following summarizes news coverage of two recent studies on breast cancer treatment.

~ Older Patients: One in five women ages 65 and older delayed or did not complete their full radiation regimen after breast-conserving surgery, leading to an increased risk of death or recurrence, according to a study published online Monday in Cancer, the New York Times reports. For the study, researchers at Weill Cornell Medical College examined the medical histories of 8,000 women ages 65 and older with stage 1 breast cancer. They found that when women delayed radiation treatment by eight weeks, they were 1.4 times as likely to have a recurrence or develop a new tumor. Patients who delayed radiation treatment for 12 weeks or longer were four times more likely to have a recurrence, the study found. In addition, the researchers reported that a shortened course of radiation treatment -- defined as less than three weeks, as opposed to the typical regimen of five to seven weeks -- would increase the risk of recurrence by 32%. However, delayed or incomplete radiation did not adversely affect the health of patients with a precancerous condition known as ductal carcinoma in situ, according to the study. Lead study author Heather Gold, an assistant professor of public health at the medical college, said, "One of the big problems is that care has to be coordinated to avoid these kinds of delays and lack of completion, especially for patients from a lower socio-economic status." Larry Norton, a cancer expert at Memorial Sloan-Kettering Cancer Center, said that the delayed or incomplete treatment could have been related to lower income or education status (Rabin, New York Times, 12/2).

~ Breast Augmentation: Using a targeted radiation method called brachytherapy produced fewer complications than whole breast irradiation in breast cancer patients with breast augmentations, according to a study reported Monday at the annual meeting of the Radiological Society of North America, Reuters Health reports. The study -- conducted by Robert Kuske of the University of Arizona Health Sciences Center and Arizona Oncology Services -- examined brachytherapy treatment in 70 women with breast augmentation who developed breast cancers and underwent lumpectomies. According to Kuske, brachytherapy uses a catheter to deliver intense radiation only to the area of breast tissue surrounding the lumpectomy, meaning that only a small percentage of the augmentation is exposed. Conventional whole-breast irradiation that exposes most of the augmentation can cause the surrounding tissue to contract, which can be very painful, Kuske said. The study found that 91% of brachytherapy produced "excellent" cosmetic outcomes, while 9% produced "good" cosmetic outcomes. None of the procedures produced "fair-to-poor" outcomes. Kuske said, "Normally, with whole breast irradiation, 15% to 20% of patients have a fair-to-poor outcome, and 55% of women with augmentations have fair-to-poor outcome." According to Kuske, brachytherapy also produces better tumor control and fewer complications. In addition, the therapy involves a five-day course of treatment, compared with six-and-a-half weeks for whole breast irradiation. However, Kuske added that he is not aware of any other providers offering brachytherapy. He currently is enrolling women without breast augmentations in a study that will evaluate the efficacy of brachytherapy in women in the general breast cancer population, Reuters Health reports (Kerr, Reuters Health, 12/1).

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