Elderly breast cancer patients may be receiving unnecessary radiation treatment, reported Medical News Today. A study published in the journal Cancer followed up on the findings of a 2004 randomized clinical trial.
The earlier research supported the omission of radiation treatment for elderly patients in an early stage of breast cancer. Specifically, for patients that received surgery and the drug tamoxifen, radiation did not improve 5-year recurrence and survival rates.
Results published in 2004 from a large, randomized clinical trial showed that adding radiation therapy to surgery plus tamoxifen does not reduce 5-year recurrence rates or prolong survival in elderly women with early stage tumors. Despite the findings, many doctors still administer radiation to these patients.
Now, the new study has demonstrated that there has been no reduction in this treatment practice. Among women over the age of 70, the study found that 76.5 percent received radiation treatment as compared to 68.6 percent at the time of the 2004 study. There was a reduction between 2005 and 2009 to 61.7 percent, but that trend did not stick. One important shift in treatment that was observed was less use of radiation to the whole breast and more use of treatment targeted at a specific area.
The American Society for Radiation Oncology has also been updating guidelines on use of radiation treatment. Their guideline focuses on using radiation therapy on the whole breast sparingly. However, when used on appropriate candidates, whole-breast radiation may help reduce the need for surgery.
"Our findings highlight the fact that it may be challenging for practitioners to incorporate clinical trial data that involves omitting a treatment that was previously considered standard of care," said Dr. Blitzblau. She noted that there could be many reasons for this, including concern about the relatively short duration of follow-up of five years. "If a treatment regimen has been working well, and data are new, there can be concern that de-escalation of treatment may ultimately be shown to worsen outcomes." However, the medical community as a whole is aware that there is a need for more financially efficient medical care that omits unnecessary treatments.
The new study was based on data from the Surveillance, Epidemiology, and End Results (SEER) Program, supported by the National Cancer Institute. The SEER Program aims to be an authoritative source of information on cancer incidence and survival in the U.S. SEER currently houses cancer incidence and survival data from population-based cancer registries. In total, the SEER Program has data that covers 28 percent of the U.S. population.