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Early Breast Cancer Diagnosis Can Mean Accelerated Treatment

Posted on: Wednesday, 16 November 2005, 21:00 CST

By Jane Oppermann

Routine mammograms are helping save women's lives, and also a great deal of their time. Just ask Antoinette Connolly.

Like many women, Connolly had been a bit casual about getting her annual breast cancer screening. Three years ago, the busy 78- year- old decided to get serious about that yearly mammogram. Two months ago, the director of human resources at Chicago's Misericordia Heart of Mercy found out, thanks to a routine screening, that she had breast cancer.

That early diagnosis meant the Highland Park resident was a candidate for accelerated partial breast irradiation, a recently developed radiation treatment that cuts treatment time in half, reduces or eliminates side effects and helps keep cancer from coming back. The new therapy is considered a good option for patients over age 50 who are postmenopausal with early-stage breast cancer.

"Early screening is working, which gives us an option to do things like this therapy, which didn't exist until five or six years ago," explained Dr. Michael LaCombe, a radiation oncologist at Condell Medical Center in Libertyville and at Highland Park Hospital.

The new treatment is less toxic, just as effective and more convenient for patients, he said.

Breast cancer is the most frequently diagnosed cancer in the United States, accounting for nearly one in every three cancers diagnosed, said the American Cancer Society. Advances in both early detection and treatment of breast cancer have resulted in decreased death rates in the past 15 years. Fifty percent of breast cancer is diagnosed in women over age 65, reported The National Breast Cancer Foundation.

Older women typically have much less aggressive disease than younger women. When breast cancer is found early, the five-year survival rate is 96 percent. There are more than 2 million breast cancer survivors in America today.

Standard radiation treatment is one reason for such survival rates. The procedure, however, involves five to six weeks of almost- daily treatment, with all breast tissue exposed to radiation. Some patients have side effects such as burning, itching, sore and possibly peeling skin and fatigue.

LaCombe and other oncology experts were frustrated that even though there is a better outlook for patients who receive radiation after a lumpectomy, 25 percent do not come back for radiation treatment. Many attribute the compliance gap to the inconvenience, fear of side effects, the length of treatment and transportation challenges over such an extended period of time.

Accelerated partial breast irradiation, however, cuts through many of those drawbacks. The treatment limits radiation exposure to the tumor area, where there is the greatest risk of recurrence. Radiation is given at higher doses for shorter times, such as five to 16 days vs. five to seven weeks.

There are several versions of this type of treatment. In some, one or more catheters are placed through the breast to hold radioactive "seeds" that deliver radiation. The therapy Connolly received is known as intensity modulated radiation therapy, which is noninvasive. With this version, the radiation dose is sculpted to conform to the shape and size of the tumor, focusing a higher radiation dose to the area where the tumor was removed while minimizing radiation exposure to surrounding normal tissues.

Though studies are still under way to determine the long-term success of such treatment, Connolly said she is grateful for the ease and convenience of the therapy. She missed just a few days of work following the removal of the tumor, then went for radiation at 7 a.m. daily for 16 days, before work. Her 88-year-old husband, John, who volunteers every day at Misericordia, drove her to treatments and read the paper during the five- to seven-minute treatment sessions.

"When the doctor told me it was cancer, I thought I was going to die," Connolly said. "But here I am, I feel wonderful, thank you. My routine was not interrupted in any way and I had no problems, no pain, no discomfort, no itching. You can't do better than that."

Source: Daily Herald; Arlington Heights, Ill.

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