Wake Radiology Oncology Services > Specialties

The leading cancer in women is breast cancer. ¹
It is estimated that one in eight women in the United States will develop breast cancer during her lifetime. ¹
Approximately one million women in the U.S. are living with breast cancer: two million who have been diagnosed and an estimated one million who do not yet know they have the disease. ²
An estimated 211,240 cases of invasive breast cancer and 58,490 cases of ductal carcinoma in situ (DCIS) are expected to occur among women in 2005. (An invasive breast cancer is defined as having spread beyond the layer of cells where it started to nearby tissues. DCIS is the earliest form of breast cancer, in which cancer cells are located within a duct and have not invaded the surrounding fatty breast tissue.) ³
The risk of developing breast cancer increases with age. The majority of new breast cancer cases, nearly 80 percent, occur in women older than age 50. ^{4, 5}
White women have a greater risk of developing breast cancer than black women; however, black women diagnosed with breast cancer are more likely to die of the disease. ⁵
When breast cancers are discovered at an early, “localized” stage and treated (the current standard of treatment for early-stage breast cancer is lumpectomy followed by radiation), there is a 97 percent rate of five-year survival. ¹
The National Cancer Institute has stated that breast-conserving therapy is “preferable” to mastectomy for most early cancer patients. The procedure involves a lumpectomy and examination and removal of the under-arm lymph nodes, followed by a course of radiation therapy. ⁶
Two groups (Fisher et al. and Versonesi et al.) reported in the October 17, 2002 issue of the New England Journal of Medicine that women with relatively small breast cancers who were treated with breast conservation surgery plus radiation therapy were as likely to be alive and disease-free 20 years later as women treated with mastectomy. ^{7, 8}
Up to 40 percent of patients with early-stage breast cancer still opt for a mastectomy, despite comparable long-term recurrence and survival rates.
The American Brachytherapy Society’s 2003 recommendations support the use of partial breast irradiation in women over age 45 with small tumors (three centimeters or less) who meet other technical criteria. ¹⁰
When considering patients for treatment with accelerated partial breast irradiation (APBI) in lieu of whole breast irradiation, the American Society of Breast Surgeons and The American Brachytherapy Society recommend that the woman be over the age of 45 with a small total tumor size (three centimeters or less), among other selection criteria.^10,11
When attention is given to patient selection and adequate brachytherapy quality assurance, the local recurrence rate among accelerated partial breast irradiation treatments is less than five percent. ¹⁰
Logistical barriers of time and travel with standard whole-breast treatment have pushed a number of women toward the choice of mastectomy (when they would rather preserve their breast) or toward lumpectomy only (where they face an increased risk of in-breast failure). ¹⁰

References

CA Cancer J Clin 2005;55:10-30.
National Breast Cancer Coalition, 2002.
American Cancer Society, 2003.
National Cancer Institute, 2001.
American Cancer Society, “Breast Cancer Facts and Figures: 2001-2002.”
National Alliance of Breast Cancer Organizations, 2003.
N Engl J Med 2002 Oct 17;347(16):1233-41.
N Engl J Med 2002 Oct 17;347(16):1227-32.
National Cancer Institute
Brachytherapy 2002:1;184-190.
“Consensus Statement for Accelerated Partial Breast Irradiation,” American Society of Breast Surgeons, 2005.