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SURGERY ISN'T ALWAYS ANSWER FOR BREAST CANCER, UTAHN SAYS

Most of the Utah doctors who deal with breast-cancer patients are surgeons. Their recommendation for treatment is generally surgery.

But the Thursday edition of the New England Journal of Medicine reports radiation therapy provides an effective alternative - preserving the breast - without causing significant threat of cancer in the untreated breast.In an interview Thursday, Dr. Frederic Gibbs, chief of the radiation therapy section at the University of Utah Hospital, says Utah surgeons have resisted radiation, but this study shows that radiation is low-risk when used in the proper quantity.

"Countries such as Europe and France have used radiation as the preferred treatment for years," said Gibbs. "But Utah surgeons have been slow to get the message. Their patients are concerned they are not being offered an alternative to a modified radical mastectomy."

There has been the misperception that there are still many undisclosed adverse affect of radiation treatment, he said. A common excuse by Utah physicians is that radiation treatment is not readily accessible. But Gibbs argues that radiation is available to any woman living on the Wasatch Front or in St. George.

With the radiation alternative, the cancer tumor is first surgically removed, leaving the breast intact. Follow-up treatment then requires receiving radiation every day for six weeks to eradicate anything remaining of the cancerous tumor, said Gibbs.

"If the radiation is carefully monitored, there is not a risk."

The NEJM study removes one more argument that has been proposed against breast-conservation treatment employing radiation therapy, he said.In 1990, a National Cancer Institute Consensus Panel on breast-cancer management chose tumor excision (a lumpectomy) combined with radiation as the preferred treatment for most patients with early breast cancer because it provides survival rates equivalent to more extensive surgery - and preserves the breast.

Some areas of the country such as California, the northeast and Chicago "seem to be getting the message of using radiation instead of a mastectomy," he said.

The University of Utah Division of Radiation Oncology has been assisting with the development of a system that further optimizes and simplifies radiation treatment to the breast. "This system is manufactured by Diacor Inc., a Salt Lake high-tech medical equipment firm that is representative of the increasing importance of this type of industry in Utah," Gibbs said.