Shorter Course of Breast Cancer Radiation Beneficial After Mastectomy

Findings from a new study published by the Journal of Clinical Oncology suggest that patients with breast cancer who underwent a mastectomy may benefit from a shorter course of radiation.

Traditionally, patients undergo 6 weeks of radiation. In the phase 2 clinical trial, the authors examined the safety and efficacy of treating patients with 3 weeks of the treatment instead.

“These women did as well, if not better, than expected, in regards to their treatment side effects and low breast cancer recurrence rates,” said study leader Matthew Poppe, MD. “Based on this small study, it appears likely that a short course of radiation may be as safe and effective as the traditional 6-week course.”

The study was designed to create a shorter, more convenient treatment for patients who have received a mastectomy, as treatment 5 days per week for 6 weeks can result in financial, work, family, and emotional stress, according to the study.

The authors believe that a shorter course of radiation can offer patients with breast cancer important benefits over longer treatments.

“It’s about improving the quality of life of women with breast cancer,” Dr Poppe said. “It gives them 3 weeks of their life back. There will be significant cost savings in not having to miss 3 extra weeks of work. There’s less strain on their family, less time away from home, less financial out-of-pocket costs. We also know that getting post-mastectomy radiation actually improves survival. But 6 weeks of radiation is often not possible for women living away from a cancer center, so many women elect to forgo radiation therapy after mastectomy. In making radiation therapy more convenient, we are potentially saving lives.”

With earlier stage breast cancer, patients receive a lumpectomy and shorter courses of radiation, which has been observed to be safe and effective.

With more advanced disease, patients may require a mastectomy and lymph node treatment. For those who require lymph node radiation, patients can experience permanent arm swelling, according to the authors.

Included in the study were 69 patients with breast cancer who were followed for an average of 32 months, according to the study. The investigators sought to determine if higher daily doses of radiation would increase the risk of complications, including infections and wound healing related to the surgery.

The findings suggest that shorter courses of treatment were safe and would not increase the risk of complications.

“Women had less skin redness and less fatigue than historical averages. We had no significant toxicities, which is very promising. Only half of women had breast reconstruction in our study, but the reconstruction complications were similar to what we’ve seen in other trials with a longer course of radiation,” Dr Poppe said. “We hope in time this will result in improved cosmetic outcomes, as other studies have shown that by shortening the course of radiation, cosmetic outcomes are improved.”

A phase 3 clinical trial is set to begin later this year and will directly compare shorter versus longer courses of radiation. This trial is necessary to show that the shorter course is safe and effective as the longer treatment among women who have undergone reconstruction, the study concluded.