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JNCI Journal of the National Cancer Institute 2007 99(5):340-341; doi:10.1093/jnci/djk085
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© The Author 2007. Published by Oxford University Press.

EDITORIALS

Local Recurrence or Cardiovascular Disease: Pay Now or Later

Sharon H. Giordano, Gabriel N. Hortobagyi

Affiliation of authors: Department of Breast Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, TX

Correspondence to: Sharon H. Giordano, MD, MPH, Department of Breast Medical Oncology, The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe, Box 1354, Houston, TX 77030-4009 (e-mail: sgiordan@mdanderson.org).

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Radiation therapy is an essential component of the local management of breast cancer. The overview from the Early Breast Cancer Trialists’ Collaborative Group (1) indicates that adjuvant radiation therapy after breast-conserving surgery results in statistically significant reductions in the 5-year risk of local recurrence (26% versus 7%), the 15-year breast cancer mortality risk (5.4% reduction), and overall mortality (5.3% reduction). The benefits of radiation therapy are similar for those patients treated after mastectomy, with reductions in local recurrence, breast cancer mortality, and overall mortality. Although the overview clearly shows the benefit of radiation, it also has confirmed the toxicities. Patients who were treated with radiation had increased risk of contralateral breast cancer, lung cancer, and mortality from cardiac disease (rate ratio = 1.27, P<.001). The . . . [Full Text of this Article]


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