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, he added.
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," he added.
"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 treatment."