New radiotherapy regime benefits young women with breast cancer

October 26, 2004

Women under 35 years of age with breast cancer can have an almost 20% lower risk of their disease recurring if they are treated using a new radiotherapy regime. These were some of the results presented here today (Tuesday 26th October) by Prof. Harry Bartelink and his colleagues at the 23rd Meeting of the European Society for Therapeutic Radiology and Oncology.

The analyses were based on data from the EORTC (European Organisation for Research and Treatment of Cancer) 22881 trial with updated follow-up (median follow-up: > 6years). 5318 patients with microscopically complete excision of early breast cancer using breast-conserving surgery were randomly assigned to undergo 50Gy irradiation of the whole breast either with or without an additional 16Gy of radiotherapy to the tumour bed (radiotherapy boost). 362 local recurrences were observed: 232 in the no-boost group and 130 in the boost group, demonstrating a considerable improvement in recurrence rate in women treated with boost.

The effect of the boost treatment was of greatest benefit in the younger women, with a reduction in 5-year local disease recurrence rate from 26% to 8.5% in women under 35 years of age. In women over 60 the boost dose resulted in a reduction of 5-year local recurrence rate from 3.9% to 2.1%. The addition of a boost dose caused a slight increase in early and late side effects and increases the burden on already overstretched resources. A balance therefore needs to be struck between providing optimal care with acceptable side effects whilst taking into account the availability of resources.

The trial data was used to estimate the impact on the 5-year local recurrence rate of a treatment policy restricting boost irradiation to patients below a certain age threshold. If no patients received a boost then the overall local recurrence rate would be 6.5%, whilst treating all patients with a boost would result in a recurrence rate of 3.6%. A policy limiting the boost dose to patients 40 years old or younger (or 8.4% of the total) would result in an overall 5-year local recurrence of 5.7% in the whole population. By increasing the threshold to 50 years (boost given to 34% of the total) the 5-year local recurrence rate reduces further to 4.8% - equivalent to the local control achieved by mastectomy.

"This evidence suggests that a 16Gy boost is a tolerable and viable alternative to total mastectomy, achieving similar local recurrence rates as the latter whilst sparing patients the necessity of breast removal", said Prof. Bartelink. "These results are so conclusive that this new approach should be immediately implemented in cancer treatment centres as a new standard of care for women under 51 years old".

"Increasing the amount of radiation given in the boost dose for younger patients, those 50 years old or younger, may improve the results even further. This is currently being investigated in a new trial", said Prof. Bartelink. "Another trial, using microarray molecular technology, is also underway which aims to develop techniques which will predict how individual women will respond to radiotherapy and therefore predict which women should receive a boost dose".
-end-


ECCO-the European CanCer Organisation

Related Breast Cancer Articles from Brightsurf:

Oncotarget: IGF2 expression in breast cancer tumors and in breast cancer cells
The Oncotarget authors propose that methylation of DVDMR represents a novel epigenetic biomarker that determines the levels of IGF2 protein expression in breast cancer.

Breast cancer: AI predicts which pre-malignant breast lesions will progress to advanced cancer
New research at Case Western Reserve University in Cleveland, Ohio, could help better determine which patients diagnosed with the pre-malignant breast cancer commonly as stage 0 are likely to progress to invasive breast cancer and therefore might benefit from additional therapy over and above surgery alone.

Partial breast irradiation effective treatment option for low-risk breast cancer
Partial breast irradiation produces similar long-term survival rates and risk for recurrence compared with whole breast irradiation for many women with low-risk, early stage breast cancer, according to new clinical data from a national clinical trial involving researchers from The Ohio State University Comprehensive Cancer Center - Arthur G.

Breast screening linked to 60 per cent lower risk of breast cancer death in first 10 years
Women who take part in breast screening have a significantly greater benefit from treatments than those who are not screened, according to a study of more than 50,000 women.

More clues revealed in link between normal breast changes and invasive breast cancer
A research team, led by investigators from Georgetown Lombardi Comprehensive Cancer Center, details how a natural and dramatic process -- changes in mammary glands to accommodate breastfeeding -- uses a molecular process believed to contribute to survival of pre-malignant breast cells.

Breast tissue tumor suppressor PTEN: A potential Achilles heel for breast cancer cells
A highly collaborative team of researchers at the Medical University of South Carolina and Ohio State University report in Nature Communications that they have identified a novel pathway for connective tissue PTEN in breast cancer cell response to radiotherapy.

Computers equal radiologists in assessing breast density and associated breast cancer risk
Automated breast-density evaluation was just as accurate in predicting women's risk of breast cancer, found and not found by mammography, as subjective evaluation done by radiologists, in a study led by researchers at UC San Francisco and Mayo Clinic.

Blood test can effectively rule out breast cancer, regardless of breast density
A new study published in PLOS ONE demonstrates that Videssa® Breast, a multi-protein biomarker blood test for breast cancer, is unaffected by breast density and can reliably rule out breast cancer in women with both dense and non-dense breast tissue.

Study shows influence of surgeons on likelihood of removal of healthy breast after breast cancer dia
Attending surgeons can have a strong influence on whether a patient undergoes contralateral prophylactic mastectomy after a diagnosis of breast cancer, according to a study published by JAMA Surgery.

Young breast cancer patients undergoing breast conserving surgery see improved prognosis
A new analysis indicates that breast cancer prognoses have improved over time in young women treated with breast conserving surgery.

Read More: Breast Cancer News and Breast Cancer Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.