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28 January 2015, 08:10
Some women with breast cancer could be spared debilitating radiotherapy after undergoing surgery without harming their chances of survival, new research suggests.
Older women with some types of early-stage cancers who undergo "breast-conserving surgery'' and post-op hormone therapy gain very little added benefit from radiation treatment, according to a team from the University of Edinburgh.
The scientists, who studied more than 1,300 patients, suggest that carefully chosen sufferers at low risk of recurrence could be spared the side effects of radiotherapy, which often include fatigue and nausea.
Professor Ian Kunkler, of the University of Edinburgh's Cancer Research Centre, said: "While radiotherapy will remain the standard of care for most women after breast-conserving surgery, the absolute reduction in risk of recurrence from radiotherapy in low-risk older women receiving hormone treatment is very modest.
"This makes omission of radiotherapy an option for selected older patients.''
The Edinburgh team led a random international trial of 1,326 patients aged over 65 with early-stage, "hormone-receptor positive'' breast cancers. Their tumours were surgically removed and had not spread to the underarm lymph nodes.
Half of the women were given radiation treatment as well as hormone treatment and half were given hormone treatment alone.
Writing in the journal Lancet Oncology, published today, the team said that after five years 89 women had died. Eight out of 49 women who had not received radiotherapy died of breast cancer, against four of 40 deaths in women who did receive radiotherapy.
About 1%of those given radiation had cancer recur in the treated breast versus 4% of those who did not receive radiotherapy.
One breast cancer charity said radiotherapy was a big fear factor for some patients, who would welcome the news, but stressed that radiotherapy was still an effective treatment.
Dr Emma Pennery, clinical director of Breast Cancer Care, said: "We know that some older women find the prospect of radiotherapy such a burden they opt to have a mastectomy to avoid it. So this research will be hugely welcomed by many patients.
"Radiotherapy can cause side effects such as pain and fatigue, which can be very daunting. Existing health conditions or reduced mobility also mean some older women have a lot of difficulty attending regular radiotherapy sessions.
"However, this study is on a group of patients with a particular kind of breast cancer. Findings also show rates of local recurrence were nearly 3% higher in women who didn't have radiotherapy treatment.
"Radiotherapy is still a highly effective treatment for many women with breast cancer.''