Breast-conserving surgery without radiation therapy is not an
effective treatment for early-stage breast cancer, a Harvard Medical
School study concludes.
The study results were presented at the annual meeting of the
American Society for Therapeutic Radiology and Oncology (ASTRO)
in Miami Beach, Florida, by Dr. James Hayman of the Joint Center
for Radiation Therapy, Harvard Medical School.
According to Dr. Hayman, the study team was surprised that a substantial
number of patients who were not given radiation therapy had cancer
recur in their breasts. These patients, he explained, were very
carefully chosen because all indications were that they would
do well with lumpectomy alone.
The 3-year rate of repeat cancer in the breast in this group was
more than 10%, according to Dr. Hayman.
In 76% of the patients, breast cancer was first detected by mammography-an
indication that the cancer was small and could not even be felt.
Nevertheless, lumpectomy alone did not prove to be as effective
as conservative surgery combined with radiation therapy has been,
Overall, of a total of 87 patients who had lumpectomy but no radiation
therapy, 14 have had a recurrence of breast cancer, Dr. Hayman
said. This recurrence rate of 16% represents "a substantial
risk of local recurrence following treatment with lumpectomy alone,"
"At this time, we are not able to identify any group of patients
with early breast cancer who are candidates for conservative surgery
without radiation therapy," Dr. Hayman said. "Surgery
alone for early-stage breast cancer does not appear to be an acceptable