How old do you have to be to avoid radiation therapy after lumpectomy?

When I was in practice, women would often ask if they really needed to get radiation therapy to the breast after lumpectomy. There was no question that for younger women, radiation was important. Without it the chances were pretty good that the cancer would come back sometime in their life. But what if the woman was over 70? We know that in general, breast cancers in this age group are typically not very aggressive or life threatening. And the inconvenience of those daily visits, often for 6 or 7 weeks was a lot for an older person. My default position was that the radiation was probably not necessary if the cancer was loaded with estrogen receptors and the woman would take tamoxifen for 5 years. And that turns out to be the case. In the July 1 issue of the Journal of Clinical Oncology, a study was published that showed women over 70 could avoid radiation under certain circumstances. The cancer needed to be smaller than 2 centimeters (a little less than an inch) in diameter. It had to have estrogen receptors and not have spread to the lymph nodes under the arm (or anywhere else). In the study, women who were older than 70, with this kind of breast cancer, were divided into two groups. Both were treated with tamoxifen for five years, but only one group received radiation to the breast. The study began in 1994, so we have a real good look at long term data. In fact, by the time this was published around two-thirds of the women had died. But the important fact is that the g...
Source: Dr.Kattlove's Cancer Blog - Category: Oncologists Source Type: blogs