Many Breast Cancer Patients Don’t Need Radiation After Surgery
Radiation therapy is often given to breast cancer patients after surgery to destroy any remaining cancer cells and prevent the cancer from coming back. In recent years, radiation oncologists have learned how to reduce the number of treatments and deliver it more precisely to spare surrounding healthy tissue.
A trial published in The New England Journal of Medicine revealed radiation to the chest wall made no difference in survival among women with early stage breast cancer with intermediate risk following a mastectomy and axillary lymph node dissection, a surgical procedure that involves removing lymph nodes from the armpit.
Similar Survival
Half of the over 1,600 patients on the trial received radiation, the other half did not. After about a decade, the survival rates were similar: 81.4% for those who received radiation and 81.9% for those who did not.
Roberto Diaz, MD, PhD
However, Moffitt Cancer Center experts warn the trial has limitations.
“When this trial opened around 15 years ago, the standard of care was to perform axillary lymph node dissections, which yielded about a 20% risk for lymphedema. Nowadays, surgeons avoid doing this procedure whenever possible and perform a sentinel lymph node biopsy followed by radiotherapy,” said Roberto Diaz, MD, PhD, a breast cancer radiation oncologist at Moffitt. “The risk of lymphedema by doing this is now less than 10%.”
Better Personalization
While it is difficult to assess the benefit of the trial’s results, radiation continues to evolve in breast cancer treatment.
“We have learned more about the biology of breast cancer, and in some patients with early stage breast cancer following breast conserving surgery and in lower risk women following a mastectomy, radiation therapy can be safely omitted,” said Kamran Ahmed, MD, a breast radiation oncologist at Moffitt. “There are many efforts underway to use genomics to personalize radiation therapy recommendations following breast conserving surgery and mastectomy. It is best for patients to consult with their radiation oncologist to see if they are candidates for excluding radiation therapy from their care.”
