Our Summary

This study looked at the use and cost of a specific type of radiotherapy called intensity modulated radiotherapy (IMRT) in older women with early-stage breast cancer, before a recommendation was made against its routine use in 2013. The researchers used records from a national cancer registry linked with Medicare claims to find women over 66 who had a first diagnosis of stage I or II breast cancer between 2008 and 2011. They then compared the use and cost of IMRT versus conventional radiotherapy. The use of IMRT varied greatly across different cancer registries, and was more likely to be used in women with left-sided breast cancer, those living in big cities, those living in areas with a median income of $90,000 or less, and those treated at free-standing facilities. The cost of care in the year after diagnosis was on average $8,499 higher for women treated with IMRT. The researchers concluded that there is potential to reduce variation in treatment and the cost of care by better aligning practice with clinical guidelines.

FAQs

  1. What is intensity modulated radiotherapy (IMRT)?
  2. How does the cost of IMRT compare to conventional radiotherapy for early-stage breast cancer?
  3. What factors influenced the use of IMRT in older women with early-stage breast cancer?

Doctor’s Tip

A doctor may tell a patient undergoing lumpectomy that it is important to follow up with regular screenings and mammograms to monitor for any recurrence or new developments in the breast tissue. They may also advise the patient to maintain a healthy lifestyle, including regular exercise and a balanced diet, to help reduce the risk of cancer returning. Additionally, the doctor may recommend seeking support from a therapist or support group to cope with any emotional or psychological effects of the diagnosis and treatment.

Suitable For

Patients who are typically recommended lumpectomy include those with early-stage breast cancer (stage I or II) who have small tumors and do not have a high risk of recurrence. Lumpectomy may also be recommended for patients who prefer breast-conserving surgery over mastectomy. Additionally, lumpectomy may be recommended for patients who are unable to undergo more extensive surgery due to age, health conditions, or personal preferences.

Timeline

Before lumpectomy:

  1. Patient undergoes initial screening and diagnostic tests to detect breast cancer.
  2. Upon diagnosis, patient discusses treatment options with their healthcare provider, including lumpectomy.
  3. Patient may undergo further tests and consultations to prepare for the surgery.
  4. Patient schedules the lumpectomy procedure.

After lumpectomy:

  1. Patient undergoes the lumpectomy surgery to remove the tumor and surrounding tissue.
  2. Recovery period following surgery, which may include pain management and monitoring for any complications.
  3. Patient may undergo additional treatments such as radiation therapy or chemotherapy, depending on the specifics of their case.
  4. Patient follows up with their healthcare provider for post-operative care and monitoring for any recurrence of cancer.
  5. Patient may undergo reconstruction surgery or other procedures to address any changes in appearance or function resulting from the lumpectomy.

What to Ask Your Doctor

  1. What is a lumpectomy and why is it being recommended for me?
  2. What are the risks and potential complications associated with a lumpectomy?
  3. How will the lumpectomy affect my breast appearance and sensation?
  4. What is the recovery process like after a lumpectomy?
  5. Will I need additional treatments, such as radiation therapy or chemotherapy, after the lumpectomy?
  6. Are there alternative treatment options to a lumpectomy that I should consider?
  7. How often will I need follow-up appointments and imaging tests after the lumpectomy?
  8. What are the chances of the breast cancer returning after a lumpectomy?
  9. Are there any lifestyle changes or precautions I should take after the lumpectomy to reduce the risk of recurrence?
  10. How will the lumpectomy affect my overall quality of life and long-term prognosis?

Reference

Authors: Halasz LM, Patel SA, McDougall JA, Fedorenko C, Sun Q, Goulart BHL, Roth JA. Journal: PLoS One. 2019 Sep 30;14(9):e0222904. doi: 10.1371/journal.pone.0222904. eCollection 2019. PMID: 31568536