Older women with a diagnosis of early breast cancer can safely opt out of radiation therapy following surgery, a new analysis indicates.
The new data suggests that women older than 65 with hormone receptor-positive breast cancer would not benefit from radiotherapy after breast-conserving surgery and hormone therapy, as it does not impact death rates or metastasis risk. Although the addition of radiation therapy did reduce cancer recurrence, the risks remain within acceptable clinical ranges without the added treatment.
The randomized trial took place over a 10-year period and included a total of 1,326 women with early, ‘low-risk’ breast cancer. The women were divided into two groups—one who received whole-breast radiation therapy and one who did not. All women underwent breast-conserving surgery and a minimum of five years of hormone therapy.
After a median follow-up period of 9.1 years, the local recurrence rate was 0.9% for the radiotherapy group and 9.5% in the non-radiotherapy group. The 10-year incidence of distant recurrence as a first event was similar between the two groups, but 10-year overall survival was nearly identical between the groups, at 80.8% and 80.7%, suggesting that the addition of radiation therapy in this group of woman has little impact on outcomes.
The experts also noted that most causes of death in their study could be attributed to reasons other than breast cancer.
Co-author of the study, Ian Kunkler, Professor of Clinical Oncology at the University of Edinburgh, commented on the positive impact the findings could have on patients:
“Radiotherapy can place a heavy burden on patients, particularly older ones,” Kunkler noted. “Our findings will help clinicians guide older patients on whether this particular aspect of early breast cancer treatment can be omitted in a shared decision-making process, which weighs up all the risks and benefits.”
The study abstract can be found in the New England Journal of Medicine.
In addition to her background in journalism, Hannah also has patient-facing experience in clinical settings, having spent more than 12 years working as a registered rad tech. She joined Innovate Healthcare in 2021 and has since put her unique expertise to use in her editorial role with Health Imaging.