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Radiation without More Surgery Sometimes OK

Posted 6/4/2013

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  This report from ASCO may be the beginnings of a game changer for some women with early breast cancer. A study from The Netherlands Cancer Institute found that some women with a positive sentinel lymph node who went on to radiation therapy without the intermmediate step of a full axillary dissection did just as well as women who had another surgery. If this results holds up in other studies, it could save many women more surgical time an the increased risk of lymphedema that comes from a full axillary dissection.

  I suspect that this one report is not going to change surgical practices all over America next week. But it surely will encourage more discussion between patient and surgeon and likely will, over time, result in changing/evolving practices. Here is the start of a report from MedPage and a link to read more:

ASCO: RT Alone OK for Some Node-Positive Breast Cancers

CHICAGO -- Breast cancer patients with a positive but nonpalpable sentinel lymph node may be better off with radiation than with further axillary surgery, the AMAROS trial affirmed.

Recurrence rates came out similarly low with either treatment, at 0.5% with completion axillary lymph node dissection and 1.0% with axillary radiotherapy over 5 years, Emiel Rutgers, MD, of the Netherlands Cancer Institute in Amsterdam, and colleagues found.

Overall survival didn't differ between the groups either, they reported here at the American Society of Clinical Oncology meeting.

But surgery doubled the lymphedema risk compared with radiation alone, at 40% versus 22% at year one and 28% versus 14% at year five (both P<0.0001).

http://www.medpagetoday.com/HematologyOncology/BreastCancer/39560

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