Nearly 20% of women who would benefit from post-mastectomy radiation therapy (PMRT) are not receiving the treatment, according to the results of a study published in Cancer.
Radiation delivered after mastectomy has been shown to reduce the risk of cancer returning in the chest wall and improve survival in high-risk patients. The American Society of Clinical Oncology (ASCO) released guidelines in 2001 indicating that PMRT is recommended for patients who have cancer in four or more nearby lymph nodes and suggested for patients with T3 tumors with nearby lymph node involvement and patients with operable Stage III tumors.
Still, PMRT has been a controversial topic, and research is ongoing to determine which patients truly benefit from the additional treatment. Researchers from the University of Michigan evaluated the patterns and use of PMRT in a group of 396 women who were diagnosed with nonmetastatic invasive breast cancer in 2002 and were treated with mastectomy. The researchers surveyed the women and assessed the rates of explanation, recommendation, and utilization of PMRT based on the ASCO guidelines.
The results indicated that 19% of patients who met the guidelines for treatment with PMRT did not receive the treatment. Furthermore, 20% of patients surveyed reported that their physician did not discuss PMRT with them. The most common reason cited for not undergoing PMRT was that the physician had not recommended it.
The researchers concluded that approximately one-fifth of women who could benefit from PMRT did not receive treatment. They suggest that there may be a need to increase surgeons’ awareness of PMRT, as well as offer patients consultations with radiation oncologists.
 Jagsi R, Abrahamse P, Morrow M, et al. Postmastectomy radiotherapy for breast cancer. Cancer. 2009; 115: 1185-1193.
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