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Experts at the U.S. National Cancer Institute currently recommend that breast cancer patients who undergo mastectomy receive radiation therapy if their cancer has spread to four or more nearby lymph nodes.
However, in the new study, which tracked nearly 57,000 such breast cancer cases in the United States between 1998 and 2011, researchers found only 65 percent of patients received follow-up radiation therapy.
The researchers "were quite startled by the finding," lead author Dr. Quyen Chu, professor of surgery at Louisiana State University Health Sciences Center, said in a news release from the American College of Surgeons.
Factors such as race/ethnicity, income and education level, health insurance, where patients lived or where they were treated, or the presence of other health problems did not influence whether these patients received radiation therapy, the team found.
One factor, however, showed a strong association with receiving radiation therapy: chemotherapy. Women who had received chemotherapy had more than 5 times the odds of getting radiation treatment compared to those who had not, the study found.
About 82 percent of the patients in the study received chemotherapy. Chu theorized that women who decided to skip chemotherapy might also be less willing to undergo radiation therapy.
Still, the exact reasons why more than a third of patients forgo post-op radiation remains unclear.
"From this study, we could not tease out whether patients refuse treatment or there is a lack of awareness among women and physicians about the need for radiation therapy after mastectomy for locally advanced breast cancer," Chu said.
If women with locally advanced breast cancer plan to have a mastectomy but are not offered follow-up radiation therapy, they should ask their doctor why, he recommended.
The study was published online recently in the Journal of the American College of Surgeons.
-- Robert Preidt
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