Some older women with breast cancer could avoid radiotherapy, without harming their chances of survival, scientists say with a study showing that older women with early breast cancer who are given breast-conserving surgery and hormone therapy gain very modest benefit from radiotherapy.
The findings 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.
Currently older women with early hormone-sensitive breast cancer are offered surgery to remove their tumour, followed by hormone treatment and radiotherapy. Few trials have assessed the benefits of radiotherapy in older women treated by breast-conserving surgery.
Scientists at Edinburgh University led an international randomised, controlled trial of 1,326 patients aged 65 or older with early-stage, hormone-receptor positive breast cancers. Their tumours 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.
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.
[link url="http://www.ed.ac.uk/news/2015/radiotherapy-280115"]Edinburgh University release[/link]
[link url="http://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(14)71156-8/abstract"]The Lancet Oncology abstract[/link]