ASTRO Patient Summary: Lumpectomy Plus Tamoxifen or Arimidex With or Without Whole Breast Irradiation in Women with Favorable Early Breast Cancer
Carolyn Vachani, RN, MSN, AOCN
The Abramson Cancer Center of the University of Pennsylvania
Last Modified: October 25, 2005
This presentation reviewed a recent study involving postmenopausal women with early stage, hormone receptor positive breast cancer (ER+ or PR+). Some have wondered if treating these patients with lumpectomy, radiation and tamoxifen was "over treating". Would these women do just as well without the radiation, saving 6 weeks of daily trips to the radiation center and the associated side effects? One recent study (CALGB 9343) showed better disease-free survival (99% vs. 94.4%) when these women received radiation. The current study assigned women with early breast cancer from 1/96 through 6/04 to receive either lumpectomy, radiation, and tamoxifen or Arimidex (LR), or lumpectomy and tamoxifen or Arimidex (LH). Thus far, there have been a significantly higher number of recurrences at the original site of the cancer in the group that did not get radiation (13 patients vs. 1 patient in the LR group). Despite this finding, metastasis to other areas of the body and overall patient survival are equal in the two groups. This study stopped accruing patients in June 2004, so it is relatively early in the data collection. Further follow-up will help better clarify this question but, for now, radiation remains a part of the standard of care.