More Women with Breast Cancer Could Skip Harsh Radiation, Study Says

Facts

• According to a study published on Wednesday by the New England Journal of Medicine, more older women with low-risk breast cancer may not need to undergo radiation after breast-conserving surgery to increase their survival chances.¹
• Results of a Phase 3 randomized trial indicate the addition of radiotherapy, alongside breast-conserving surgery and hormone therapy, makes almost no difference to the survival rates for patients over age 65 who are treated for the disease at an early stage.²
• Results of the study also provided evidence that radiotherapy was ineffective in reducing the risk of secondary low-risk tumors or metastases.³
• Although survival rates remained very similar for those who skipped post-surgery radiation, research into 1,326 breast cancer patients 65 and older found that skipping the treatment led to higher rates of local recurrence. Some doctors argued that these results made post-surgery radiation too valuable to skip, especially for those women who are less receptive to hormone therapy.⁴
• The decade-long study discovered that the cumulative incidence of local breast cancer recurrence was 9.5% in patients treated without radiotherapy and 0.9% in patients who underwent radiation. However, because overall survival rates remained identical, the results bring into question the universal application of post-surgery radiotherapy — an expensive, time-consuming treatment that often produces severe and unpleasant side-effects in cancer patients.⁵
• Invasive breast cancer reportedly affects nearly 300K women in the United States — most of them aged 62 or older — and is the second leading cause of cancer death in women in the US.⁶

Sources: ¹Wall Street Journal, ²Healio, ³Ethealthworld.com, ⁴Medpage today, ⁵Stat and ⁶Breast cancer statistics.

Narratives

• Narrative A, as provided by Independent. These findings offer a glimmer of hope to the long-standing problem of overtreatment in women with low-risk breast cancer. While the data doesn't in any way weaken the value of radiotherapy, the study's results can potentially reduce the economic burden of radiotherapy on older patients as well as improve the quality of their lives by limiting the side-effects of their treatment.
• Narrative B, as provided by Stat. Caution must be exercised in omitting radiation for cancer patients who may find it difficult to tolerate the side effects of hormonal therapy. Moreover, the choice to skip radiotherapy, if taken, must be tailored and customized to the patient’s disease, comorbidities, and preferences.

Predictions