Women with early-stage breast cancer who are at high risk for the cancer coming back can do just as well with a shortened course of radiation therapy, researchers report.
“We can treat patients with early-stage breast cancer who have a higher risk of having their tumors recur in three weeks as opposed to four or six weeks and achieve just as good tumor control with no differences in cosmetic appearance or side effects,” said study author Dr. Frank Vicini.
“This gives a lot of comfort to patients, and this approach cuts treatment time in half,” added Vicini, a radiation oncologist and national director of research and breast care services at GenesisCare in Farmington Hills, Mich.
This is a major convenience, too, cutting trips to and from the clinic for radiation treatments.
Previous studies have shown that a three-week course of radiation is as safe and effective as a six-week therapy for people at low risk of breast cancer coming back. Still, some people with early breast cancer face a higher risk of recurrence due to slightly larger tumor size or other factors like older age.
For these people, whole-breast radiation is typically given after a tumor is removed via lumpectomy and followed by a radiation boost to the surgical site delivered over six to seven days. The new study shows that the boost can be given at the same time as whole-body radiation treatment.
Calling the new findings “practice-confirming,” Vicini said this can be incorporated into clinical practice now since none of the techniques or concepts are new.
The study included about 2,300 people with early-stage breast cancer who had an increased risk of breast cancer recurrence. They were randomized into two groups: one group underwent whole-breast radiation for four to five weeks, followed by a boost to the lumpectomy site delivered over six to seven days, and the other group received whole-breast radiation over three weeks, with the boost to the surgical site given at the same time.
There were 56 breast cancer recurrences after slightly more than seven years of follow-up. There were no differences based on the treatment protocol, the study showed.
Some questions remain, such as whether people whose cancer has spread to the lymph nodes can benefit from the three-week approach as well and whether treatment time can be trimmed even more, Vicini said.
The study was presented Monday at the American Society for Radiation Oncology annual meeting in San Antonio. Findings presented at medical meetings are considered preliminary until published in a peer-reviewed journal.
Dr. Alphonse Taghian is a breast radiation oncologist at Massachusetts General Hospital and a professor of radiation oncology at Harvard Medical School in Boston.
“I am going to start using this protocol in people with early breast cancer at high risk for breast cancer recurrence as soon as I come back from the meeting,” said Taghian, who was not involved in the study. “There is no reason not to. It will save a week or more for these women who must drive every day to come for radiation, without affecting the outcome.”
Breastcancer.org provides more on radiation's role in treating breast cancer.
SOURCES: Frank Vicini, MD, radiation oncologist, national director, research and breast care services, GenesisCare, Farmington Hills, Mich.; Alphonse Taghian, MD, PhD, breast radiation oncologist, Massachusetts General Hospital, professor, radiation oncology, Harvard Medical School, Boston; American Society for Radiation Oncology annual meeting, Oct. 23-26, 2022