Cancer expert Eric Winer, MD, says he’s worried about a new study that reveals radiation treatment rates following lumpectomy for breast cancer are low across the United States. Dr. Winer, from the Dana Farber Cancer Institute, in Boston, Massachusetts, expressed his concerns to the Press before the 2008 Breast Cancer Symposium in Washington, DC, sponsored by the American Society of Clinical Oncology and several other cancer and breast disease societies.
Dr. Winer says, “I am shocked to see such low rates for radiation. This is a really important finding. “It shows that there are many women still falling through the cracks. What is happening to the 20% of women who do not have radiation? Where are they disappearing to? We must find them." Dr. Winer points out that only 74% of white women and 65% of black women received radiation after lumpectomy, saying radiation treatment… “should be a standard of care in all but the oldest and sickest women." Breast cancer survival rates are comparable to those seen in women who have mastectomy when radiation therapy is given to women after conservative surgery, yet it appears that too many women are only receiving partial therapy.
The findings come from a review of Medicare records involving 37,000 women treated in 2003 with new diagnosis of early stage breast cancer and lumpectomy - 34,024 of the women were white. Disparity was also associated with treatment of black women, with only 65% of black women receiving radiation compared to 75% of white women.
Grace Smith, MD, PhD, MPH, from the MD Anderson Cancer Center, in Houston, Texas presented the findings at the meeting, saying, "We don't know if fewer black women are receiving radiation therapy because it is not offered to them, because they decline treatment, or because they are unable to complete a whole course of treatment." Dr. Smith suggests that some work is needed to get the word out that radiation after lumpectomy provides important benefits to women for breast cancer survival.
The researchers also found that geographic location had no effect on whether radiation treatment was received, studying nearly 80,000 patient records. Their analysis showed that 39% of women in urban areas and 38% in rural areas received the recommended tratment.
Past studies have shown that radiation therapy improves survival rates in younger women who have lumpectomy for breast cancer. The benefits to women over age 70 have not been proven.
Racial disparities in treatment for early invasive breast cancer: A national Medicare study of radiotherapy after conservative surgery
Radiation therapy in urban and rural breast cancer patients