Breast cancer treatments:
Patients are not receiving recommended treatments

Researchers have found that many women with advanced cases of breast cancer do not receive the recommended treatment. Radiation treatment administered to women following mastectomy operations can be lifesaving. However, almost half of patients do not receive this treatment.

A new study published in CANCER, a peer-reviewed journal from the American Cancer Society, has found that proven treatments remain unavailable to many patients.

Clinical trials conducted during the 1990s demonstrated the benefits of radiation after mastectomy in advanced cases of breast cancer, and guidelines recommending this form of treatment were published as a result. A team led by Shervin Shirvani, MD, and Benjamin Smith, MD, of the MD Anderson Cancer Center, Houston, analysed information from over 38,000 women to ascertain whether these guidelines were being followed.

The study focused on women aged 66 years and above who were treated with mastectomy for invasive breast cancer between 1992 and 2005. Although radiation use increased from 36.5 per cent to 57.7 per cent between 1996 and 1998, no further increase was observed between 1999 and 2005. During the latter period, only 55 per cent of older, high-risk breast cancer patients received the recommended treatment.

"When physicians are not guided by published evidence, there is the chance that patient outcomes will suffer or that patients will undergo unnecessary treatments and tests," explained Dr Shivani. "Furthermore, beyond the potential for distress and injury to the individual patient, there is also the strong likelihood that medical resources will be wasted on unproven or ineffective treatments."

Whatever the reasons for such unsatisfactory levels of implementation, it seems that more work is necessary to ensure that the results of clinical trials are taken on board by medical practitioners.