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Study May Help Settle Debate Over Radiation Treatment for Internal Mammary Nodes in Post-Mastectomy Patients

PHILADELPHIA (November 1, 1999) -- The debate over the effectiveness of radiation therapy of internal mammary nodes (IMN) has re-emerged with the recent publication of "positive results" from two post-mastectomy randomized trials. However, a new study shows patients do not appear to have a significant decrease in distant metastases or improved survival rates with irradiation of the IMN. The results of the study were presented today at the American Society for Therapeutic Radiology and Oncology (ASTRO) annual conference in San Antonio, Texas.

The study, conducted at Fox Chase Cancer Center in Philadelphia, examined 1383 women who underwent a mastectomy, axillary dissection and radiation between 1979 and 1994. The median follow-up for the study was six years and the median age of the women was 55.

One hundred, fourteen women had radiation targeted to the IMN nodes and 1269 did not. At five and 10 years, there were no significant differences between the two groups in incidence of tumor recurrence, regional node recurrence, distant metastases as first site or as total failures. In addition, there were no significant differences in overall survival between the two groups.

"There is an ongoing debate about whether there is any survival increase or other benefit using radiation as a preventive treatment for internal mammary nodes," states Barbara Fowble, M.D., Associate Director of the Breast Evaluation Center at Fox Chase Cancer Center and primary author of the study. "This is the second retrospective study to show no benefit and I think that raises doubt as to the effectiveness of this treatment."

Fox Chase Cancer Center is one of 36 National Cancer Institute-designated comprehensive cancer centers in the nation. The Center's activities include basic and clinical research, prevention, detection and treatment of cancer and community outreach programs.

Fox Chase Cancer Center, part of the Temple University Health System, is one of the leading cancer research and treatment centers in the United States. Founded in 1904 in Philadelphia as one of the nation’s first cancer hospitals, Fox Chase was also among the first institutions to be designated a National Cancer Institute Comprehensive Cancer Center in 1974. Fox Chase researchers have won the highest awards in their fields, including two Nobel Prizes. Fox Chase physicians are also routinely recognized in national rankings, and the Center’s nursing program has received the Magnet recognition for excellence four consecutive times. Today, Fox Chase conducts a broad array of nationally competitive basic, translational, and clinical research, with special programs in cancer prevention, detection, survivorship, and community outreach.  For more information, call 1-888-FOX CHASE or (1-888-369-2427).

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