Radiotherapy may be unnecessary for some breast cancer patients

Radiotherapy may be unnecessary for some breast cancer patients

28 Jan 2015

According to an international randomized trial, some older women with breast cancer could safely avoid radiotherapy, without harming their chances of survival. More specifically, older women with early breast cancer who are given breast-conserving surgery and hormone therapy gain very modest benefit from radiotherapy.

The findings (published in the journal Lancet Oncology), suggest that a carefully defined group of patients who are at low risk of recurrence could avoid the health risks and side effects associated with radiotherapy, such as fatigue and cardiac damage.

An international study with more than 1,000 patients

Scientists at the University of Edinburgh led an international randomized, controlled trial (called PRIME 2) of 1,326 patients aged 65 or older with early-stage, hormone-receptor positive breast cancers. Their tumors were surgically removed and had not spread to the lymph nodes underneath the arm.

Half of the women were given radiation as well as hormone treatment and half were given hormone treatment alone.

“In some cases, radiotherapy can be omitted”

After five years, roughly 96% of both groups had survived, and most deaths were not caused by breast cancer. Around 1% of those given radiation had cancer recur in the treated breast versus 4% of those who did not receive radiotherapy.

Professor Ian Kunkler, of the University of Edinburgh's Cancer Research Centre, said: "While radiotherapy will remain the standard of care for most women after breast-conserving surgery, the absolute reduction in risk of recurrence from radiotherapy in low risk older women receiving hormone treatment is very modest. This makes omission of radiotherapy an option for selected older patients'.

Source: University of Edinburgh