HealthDay Reporter
WEDNESDAY, Sept. 21, 2016 (HealthDay News) — New guidelines issued by three leading cancer organizations suggest that more breast cancer patients should consider radiation therapy after a mastectomy.
Overall, the guidelines say there’s enough evidence to show radiation treatment after a mastectomy decreases the risk of breast cancer recurrence, and that even women with smaller tumors and three or fewer lymph nodes involved can benefit from the therapy.
“The new guidelines say there is clear evidence that the benefit of [post-mastectomy radiation therapy] extends to women with limited lymph node involvement,” said Dr. Stephen Edge. He is vice president for health care outcomes and policy at Roswell Park Cancer Institute in Buffalo, N.Y. Edge was co-chair of the panel that developed the new guidelines.
One radiation treatment expert welcomed the updated recommendations.
“The guideline is timely,” said Dr. Janna Andrews, an attending physician in radiation medicine at Norwell Health Cancer Institute, in Lake Success, N.Y. “The field of post-mastectomy radiation is changing. It’s always up for discussion now as to who needs [post-mastectomy radiation therapy].”
The new guidelines help clarify what used to be a gray area, Andrews explained. “In the past, if a woman had a small tumor, less than 5 centimeters, and not more than three or four positive lymph nodes, many doctors would say she does not need [post-mastectomy radiation therapy],” she said.
The guidelines don’t offer a single formula for which patients need radiation therapy, Edge noted. But they do focus on the group of women for whom there is the most debate about the value of radiation.
“There is a great deal of controversy about whether women with one, two or three lymph nodes [with cancer] have sufficient risk to warrant radiation,” he said. “For women with four or more lymph nodes involved, everyone would recommend radiation.”
The guidelines also strongly support input from all specialists who treat breast cancer in making the decision about radiation treatment. That typically includes the surgeon, radiation physician and an oncologist.
Doctors need to weigh the risks and benefits, Edge added. Side effects can include redness of the skin, swelling and skin breakdown severe enough to compromise future breast reconstruction, he explained.
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