What You Need To Know: The Uppsala/Orebro (Sweden) study with 10 years of follow-up was one of the first randomized clinical trials to shoe the benefit of adding whole breast radiation therapy to lumpectomy. Now, we have reaffirmation of radiation therapy benefit with 20 year follow-up.
The Evidence: A total of 381 women with stage I breast cancer were randomized to sector resection (bigger than a standard lumpectomy, but smaller than a quandrantectomy) with or without external radiation therapy (54 Gy in 27 fractions). Here are the results:
- Overall mortality 50% with radiation, and 54% without it.
- Cumulative first breast cancer event 31% with radiation, and 45% without it. The benefit of radiation was achieved within the first 5 years of followup.
My Take: This research update reaffirms the benefit of postoperative radiation therapy as a critical part of breast-conserving surgery for early invasive breast cancer. The radiation therapy appears to exert its benefit in the first 5 years, hinting at the fact that some of the later cancers developing in the breast may be new events, rather recurrences. More recent results show that a local control probability can be achieved that is much better than what was achieved in historic clinical trials.
The small print: The material presented herein is informational only, and is not designed to provide specific guidance for an individual. Please check with a valued health care provider with any questions or concerns. As for me, I am a Harvard- , Yale- and UPenn-educated radiation oncologist, and I practice in the Seattle, WA (USA) area. I feel genuinely privileged to be able to share with you. If you enjoyed today’s offering, please consider clicking the follow button at the bottom of this page.
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Reference: Journal of Clinical Oncology 2014 Mar 10; 32:791.