Study finds chest wall irradiation may be unnecessary for many breast cancer patients

By Free Republic | Created at 2024-12-19 21:27:27 | Updated at 2025-01-01 16:27:23 1 week ago

Study finds chest wall irradiation may be unnecessary for many breast cancer patients
Medical Xpress / American Assoc for Cancer Research / San Antonio Breast Cancer Symposium (SABC) ^ | Dec. 12, 2024 | Ian Kunkler, MA, MB BChir et al

Posted on 12/19/2024 1:18:56 PM PST by ConservativeMind

Patients with intermediate-risk breast cancer had similar rates of 10-year overall survival whether or not they underwent chest wall irradiation (CWI) after mastectomy, according to results from the BIG 2-04 MRC SUPREMO clinical trial.

He explained that while guidelines vary, CWI is commonly used to treat patients with intermediate-risk breast cancers, defined as patients with one to three positive lymph nodes or patients who have no positive lymph nodes but whose cancers exhibit other factors that increase the risk of recurrence, such as grade 3 histology and/or lymphovascular invasion.

To evaluate the impact of post-mastectomy CWI in patients with intermediate-risk breast cancer, Kunkler and colleagues conducted the BIG 2-04 MRC SUPREMO Phase III clinical trial. The international trial enrolled patients from several countries with:

—breast tumors 50 mm or less across (pT1-2) and one to three positive axillary lymph nodes (N1);

—breast tumors larger than 50 mm across (pT3) and node-negative disease (N0); or

—breast tumors larger than 20 mm but no larger than 50 mm across (pT2), N0 disease, and grade 3 histology and/or lymphovascular invasion.

Patients received guideline-concordant axillary node clearance and systemic treatments.

There were no significant differences in overall survival between those who received CWI and those who did not, with 81.4% and 82.0% of patients in the CWI and no CWI arms, respectively, alive after a median follow-up of 9.6 years.

Although CWI reduced the risk of chest wall recurrence by over half, the absolute rate of chest wall recurrence was reduced by less than 2%, which was clinically insignificant.

When the researchers analyzed CWI's impact in specific patient subgroups, they found that neither patients with N0 disease nor those with N1 disease experienced survival benefits with CWI, suggesting that omission of post-mastectomy CWI may be safe even for patients with lymph node-positive disease.

(Excerpt) Read more at medicalxpress.com ...

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Chest wall radiation may be unnecessary for some breast cancer patients, even some with lymph-node positive cancer.

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2 posted on 12/19/2024 1:19:25 PM PST by ConservativeMind (Trump: Befuddling Democrats, Republicans, and the Media for the benefit of the US and all mankind.)

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