At the end of a 10-year, coast-to-coast study of women with an unusual form of breast cancer, Richard J. Barth Jr., M.D., and three fellow researchers are making the case for a particular combination of treatments to stop the tumors in their tracks.
In the August 2009 issue of the Annals of Surgical Oncology, Barth, an associate professor of surgery at Dartmouth Medical School (DMS), and his colleagues -- among them Wendy Wells, M.D., a professor of pathology at DMS -- recommend using adjuvant radiotherapy on patients who undergo breast-conserving surgery to control borderline-malignant and malignant phyllodes tumors.
Following the progress of 46 women who received follow-up radiotherapy at 30 different institutions in 18 states, the research team found that none developed new tumors in the areas in which surgeons performed margin-negative resection. Among nearly 500 women nationwide who are diagnosed with the condition every year and undergo only the surgery, the researchers say, tumors recur in 24 percent of patients with borderline malignant tumors and 20 percent of those with malignant tumors.
Barth is section chief of general surgery at Dartmouth-Hitchcock Medical Center (DHMC), and Wells is a breast pathologist at DHMC, where 13 women participated in the study. The Dartmouth researchers work in the Comprehensive Breast Care Program at Dartmouth-Hitchcock's Norris Cotton Cancer Center.
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