Radiation doesn't help pts 50-75 with early stage breast cancer

What the study seems to be saying is not that radiation doesn't help these patients, but that the majority of patients are just fine, even without radiation. This isn't really news - we know that many patients are 'cured' with surgery alone. The problem however is we don't know which patients need these extra treatments (such as rads) and which don't and that's why more patients get these treatments than really need them.

It is interesting to note that the recurrence rate was 3.4% in the radiation group and 4.4% in the non-radiation group. This difference is not statistically signficant at the 95% level and therefore the conclusion is that there is no difference in results between the rads and non-rads groups. But if the sample size had been larger and if this same difference held, the results would have been considered significant.

I was 53 when dx. I had rads to my whole breast (rt side) and clavicle nodes. BMX pathology this past July showed no evidence of involvement, no hyperplasia or abnormality on the involved breast, but showed mild hyperplasia in the UNRADIATED (left) breast. Perhaps it was just a fluke, but it appears for me that rads might have helped me.

Study patients received radiation during surgery rather than after.

(HealthDay)—Some women with early breast cancer might benefit from a "one-and-done" treatment, in which they receive a single dose of targeted radiation therapy during the surgery that removes their tumor.

A pair of new studies found that this procedure works about as well as current protocols that require six weeks of daily radiation therapy following surgery.

The new procedure uses miniature devices that deliver radiation directly to the site of the tumor, while the site remains exposed by surgery following lumpectomy.

"It's right in front of the surgeon's and the radiation oncologist's eyes, so we can put the beam precisely where it is needed," said study co-author Dr. Michael Baum, emeritus professor of surgery and a principal research associate at the University College London Medical School. "We can form the cavity to the shape of the beam. It's elegant and dead simple..."

http://medicalxpress.com/news/2013-11-one-stop-treatment-breast-cancer-alternative.html

Interesting ...

If the group being studied was younger, that might be interesting. But in a group of women aged 55 - 70, over-all survival will be influenced by many things other than breast cancer and breast cancer treatment. Heart disease is the greatest cause of death among older women.

If the sample sizes were larger, then yes, eventually you would expect both groups to have the same mortality rate, and therefore, the same overall survival rate. But with a smaller sample size, random differences appear exaggerated. If just a few more women in one of the groups had other health problems or accidents that led to their death, that would appear to make the OAS numbers look very different. This is why with a smaller sample size, you require a much larger difference between the groups for the results to be statistically significant, because a shift of just 3 or 4 people can completely change the results. With larger samples, a much smaller difference would be statistically significant. This is because when a group is larger, a shift of just a few people from one side to the other doesn't have much affect on the percentages.

The other thing to consider is that when you are looking at recurrence rates, there is only one event that is being measured.... did someone have a recurrence or did they not? So it's easy to get a clean comparison. But when you are looking at survival, or more to the point, mortality, which is the inverse of survival, there are dozens of things that can happen that will influence this number, especially when you are tracking for 9 years a group of women who start out between the ages of 55 to 70. Mortality could be caused by breast cancer, or by the effects of a breast cancer treatment, but within that age group, more of the mortality would be from heart disease, lung cancer, other illnesses, accidents, etc..

New study on heart risk and rads. Not surprisingly, heart risk is strongly correlated to your risk without rads, and it goes up if you are getting rads on the left in a prone position.

http://www.oncologynurseadvisor.com/heart-disease-associated-with-breast-cancer-radiation/article/321036/

Alaska, what does EF of 70 signify? I have had echos (because I had epirubicin, which is similar to adriamycin), but so far they have been completely normal, rads, chemo and all.

Nancy, thanks for explaining. I see it on my reports. It gives the normal range as 53-77. Before treatment my score was 68, after it was 80, whatever that means.

Nancy, I made a point of walking all through chemo, then stepped the exercise up a notch once I felt better. I had that last echo around the same time as my hyster. Prior to the hyster surgery a cardiologist checked me over. Because of all the treatment, he was very careful and thorough. He asked if I was able to walk a little. I told him I usually managed about an hour a day, and the poor man was almost ready to cry, then expressed the fervent wish that all his patients would do the same.

But maybe it is bad that the number is outside the normal range?

Well, abigail, since you don't have cancer that would probably not be too difficult.

Nancy, I checked and too high may also indicate a problem. However, my docs are not worried, so I imagine there would have to be other indications for it to be a problem.

A lot of things can cause what you describe. Since it is not diagnosed one has to assume it isn't cancer.

I'm not a doctor, but there are lots of skin conditions and various types of benign growths. The fact that you've had it for so long and are still alive indicates it probably isn't cancer. Only way to diagnose cancer is through a biopsy, which you say you won't have. You can pretend all you want, but unless you get it diagnosed nobody here considers you a cancer sufferer.

Wow, I didn't realize that!