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How much breast cancer treatment is too much?

Treatments like radiation are designed to stop cancer from coming back. Now, researchers are studying the benefits of cutting back on certain treatments.

PITTSBURGH — When a woman is facing breast cancer, treatments like radiation and the removal of potentially cancerous lymph nodes are designed to stop cancer from coming back. But now, researchers are studying the benefits of cutting back on certain treatments for some patients.

Chemo, radiation, surgery, and new advances in breast cancer treatment – they’ve contributed to a 43 percent reduction in breast cancer deaths over the past 30 years.

“Through those advances, we're doing better with outcomes, but now, we're trying to make sure that we give the right treatment to the right patient," UPMC researcher  Adrian Lee, Ph.D., said.

Lee and his colleagues studied data from women over 70 with ER-positive, HER2-negative cancer. The researchers focused on radiotherapy and sentinel lymph node biopsy – two treatments that can have significant side effects.

“With sentinel lymph node biopsy, you have a risk of lymphedema, which many men and women suffer from with swollen arms,” Lee explained.

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And radiotherapy, which is designed to kill remaining cancer cells, can cause nerve pain and skin irritation. Researchers used an advanced computer program and determined that the rates of recurrence were the same, whether women had sentinel lymph node biopsy and radiotherapy or not, suggesting that those treatments can be reduced or eliminated in some patients.

“So, if we can reduce that and reduce the use of that safely in cancers where we know that they're unlikely to recur, then, that's good for everyone,” Lee added.

Lee and his colleagues initially studied de-identified data from women over age 70, because clinical trials don’t often include women in this age category. The pros and cons of aggressive treatment have been a topic for doctors and patients since 2016. That’s when The American Society of Breast Surgeons recommended surgeons and patients have frank discussions about both the benefits and risks.

If this story has impacted your life or prompted you or someone you know to seek or change treatments, please let us know by contacting David Bohlman at david.bohlman@wqad.com or Marjorie Bekaert Thomas at mthomas@ivanhoe.com.

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