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Many Breast Cancer Patients Forgoing Radiation

University of Michigan Photo Service

University of Michigan radiation oncologist Dr. Reshma Jagsi, seen consulting with a patient, says many breast cancer sufferers who need radiation therapy after a mastectomy are not getting it.

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Published: February 10, 2009

Updated:

Roughly 20 percent of women with breast cancer who should be receiving radiation therapy as a follow-up to surgery aren't getting it.

Researchers at the University of Michigan Comprehensive Cancer Center who conducted a study that uncovered this potentially deadly situation say the most common reason women cited for not considering radiation therapy was that their doctors did not recommend it.

A study led by Dr. Reshma Jagsi, assistant professor of radiation oncology at the U-M Medical School, looked at 396 women who were treated with a mastectomy for breast cancer. The researchers found that 19 percent of women who fell clearly within guidelines recommending radiation treatment after the mastectomy did not receive that treatment.

The results of the U-M study appear in the online version of Cancer and will be published in the journal's March 15 print issue.

Radiation therapy after a mastectomy is known to decrease the risk of cancer returning inside the chest wall and has been shown to reduce mortality in high-risk patients. Cancer researchers and clinicians, however, have been unable to agree which breast cancer patients are most likely to benefit from the X-ray treatments.

Despite the lack of total agreement, "There's an identifiable high-risk group for whom there's absolutely no debate - they need radiation after their mastectomy," Jagsi said.

Even within this vulnerable group only four-fifths of the women were treated with radiation after mastectomy, the study found.

"That's not good enough," Jagsi said, because "this is a potentially lifesaving treatment."

Current treatment guidelines recommend a woman receive radiation after mastectomy if she had particularly large tumors or cancer in four or more of their nearby lymph nodes. Even a woman with fewer lymph nodes with cancer cells should strongly consider radiation treatment, according to the guidelines.

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