Radiation For Breast Cancer: Less Is Best?

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A new way of delivering radiation can safely shave two to three weeks off the conventional treatment of women with early breast cancer, a European study suggests.

"The findings suggest that women can safely undergo a less demanding course of radiation therapy without appearing to increase their risk of recurrence," says researcher John A. Dewar, MD, a clinical oncologist at the University of Dundee in Scotland.

Additionally, the short course appears to cause fewer side effects, including breast shrinkage or swelling, and hardening of the breast tissue, he tells WebMD.

The findings were presented at the annual meeting of the American Society of Clinical Oncology.

Low Breast Cancer Recurrence Rates in All Groups

The study included nearly 4,500 women that had successfully undergone surgery to remove their breast tumors.

All the women received surgery and then underwent conventional external beam radiation therapy, designed to prevent recurrences. The method involves aiming a beam of X-ray radiation through the chest and under the arm to kill cancer cells.

Some women received the standard treatment of 50 Grays, the unit used to measure radiation, in 25 treatments spread over five weeks.

The others were given about 40 Grays, either in 15 treatments over three
weeks or in 13 treatments every other day for five weeks.

By about five years later, cancer had come back in 5 percent or fewer of women in all the groups.

Finding Potentially Practice-Changing

The results are "very exciting news for our patients," some of whom have to travel hundreds of miles to receive the conventional radiation regimen, says Julie Gralow, MD, assistant professor of oncology at the University of Washington in Seattle.

She notes that in the United States, women are often given a booster, bringing the total length of therapy to six to seven weeks.

"This is very disruptive to your life," Gralow tells WebMD. "If we can give less radiation, either by giving it over three weeks or by giving it every other day — that's a big advantage."

Gralow says she believes the findings are potentially practice-changing.

Some of the radiation oncologists at her institution have already indicated that they think it's a good idea, she says. Plus, "patients will push for it."

U.S. Testing Another Breast Cancer Short Course

Gralow notes that doctors at Fox Chase Cancer Center in Philadelphia are testing yet another way of delivering a short course of radiation.

That method is called intensity modulated radiation therapy, or IMRT. In IMRT, multiple radiation beams are focused at the breast from many directions. A computerized program allows doctors to adjust both the strength and the intensity of the beams so that more radiation is blasted at the tumor site and less is delivered to surrounding healthy tissue.

Additionally, the doctors added a radiation boost, a little each day, to the part of the breast where the tumor was removed.

As with the European method, the American method appears to be just as effective and perhaps safer than conventional therapy.

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By Charlene Laino
Reviewed by Louise Chang
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