Some Women W/ Luminal A BC May Be Able To Skip Rads After Lx
Some Older Women With Luminal A Breast Cancer May Be Able To Skip Radiation After Lumpectomy
June 15, 2022
Women ages 55 and older diagnosed with early-stage, estrogen receptor-positive, progesterone receptor-positive, HER2-negative breast cancer that had low levels of Ki67 protein and a very low risk of recurrence were able to safely skip radiation after lumpectomy. Read more...
Comments
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This is fantastic news, not only about the prospect of no radiation, but also reinforcing the efficacy of aromatics inhibitors.
I assume it could also be good news for women who have a second diagnosis of a small IDC and wish to avoid mastectomy?
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This is all well and good, except what if you cannot tolerate estrogen blockers, either tamoxifen or AIs? My radiologist recommended no radiation (it does not improve mortality rates) and if I had a local/regional recurrence I could always get a MX or BMX. Is that the choice, radiation now or another major operation later? Is this study looking at cost? Radiation may be preferable to 5 years of adjuvant hormone therapy: "Women age 70 or above with low-risk early breast cancer who are reluctant or unable to pursue adjuvant aromatase inhibition can safely pursue adjuvant radiation alone with limited differences in outcome and a modest increase in costs." https://pubmed.ncbi.nlm.nih.gov/31212043/
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At 68, and having read articles with results similar to what is mentioned above,I had hoped to avoid radiation after my early stage grade 2 ER PR+ Her- tumor, but my radio-oncologist strongly recommended it as there were 2 small tumors in addition to the main 2 cm one, and nerve involvement. She was more flexible when I said I hoped to avoid the AI that was recommended; when she said it would add about 3% extra protection, I declined. She said the rad was more important.
So now, 2.5 yrs later I have a local recurrence and since it is close to skin (the excision for examination was actually from the skin, according to surgeon), a total mastectomy is the treatment (removing skin patch). Would taking the AI have made a difference? I guess I'll never know. But to be safe, quite likely I will consent this time around!
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Happyhiker1, Sorry to hear that you had a local recurrence after rads. From what I read when I chose to undergo radiation, radiation is more effective than an AI at preventing a local or regional recurrence, but of course both are better, with an AI adding protection against a new primary and distant recurrence. I met a woman who did not have either after a lumpectomy, then four years later had new primaries in both breasts, had a BMX, and is now on an AI, like it or not. These treatments are not failsafe, that's for sure, and we have to make decisions by judging risk and our personal tolerance for it.
Be well.
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