A new American study has found women who have had mastectomy and would benefit from radiation therapy are less likely to receive it than those who have had lumpectomy.
The research, conducted by scientists at the University of Michigan Comprehensive Cancer Center, has appeared in the Journal of Clinical Oncology.
The study analysed 2,260 women treated for breast cancer, assessing whether they had lumpectomy or mastectomy, and whether they would be strong candidates for radiation therapy.
Women who have particularly large tumours or cancer in four or more of their nearby lymph nodes are recommended to have radiation after mastectomy.
The research discovered that among patients who should receive radiation therapy according to medical guidelines, 95 per cent of those who had lumpectomy went on to receive radiation, but only 78 per cent of those who had mastectomy received radiation.
Among women for whom radiation is less clearly beneficial, 80 per cent of the lumpectomy patients had radiation while only 46 per cent of the mastectomy patients did.
Author Reshma Jagsi, assistant professor of radiation oncology at the U-M Medical School, said: "A substantial number of breast cancer patients are being undertreated. One in five women with strong indications for radiation after mastectomy failed to receive it. Radiation can be a life-saving treatment."
She went on: "The fact that 95 percent of patients who had lumpectomy received radiation in the two metropolitan areas we studied indicates that we can do better than we are currently doing for the selected mastectomy patients who also need radiation. More attention needs to be paid to radiation after mastectomy."
The study also demonstrated that doctor participation strongly influenced radiation receipt.
Patients who reported their surgeon was involved in the decision to receive radiation were more likely to receive radiation than patients whose doctor was less involved.
Jagsi said: "Even patients who wanted to avoid radiation therapy were very likely to receive it if their surgeons were highly involved in the decision process. We need to do a better job of educating both patients and physicians regarding the benefits of radiation after mastectomy in certain circumstances, and we need to encourage physicians to help their patients as they make these important decisions."