Breast Cancer Study Shows New Radiation Therapy Not as Safe, Effective

Refinement of the treatment plan during the brachytherapy procedure.

A breast cancer study being presented Wednesday at the San Antonio Breast Cancer Symposium in Texas shows that a faster form of radiation therapy may not be as safe and effective as conventional radiation treatment, The New York Times reports.

According to the study of more than 130,000 women receiving Medicare, women who underwent Brach therapy were twice as likely as those who underwent conventional whole breast radiation to have a mastectomy in the five years following the procedure — a sign that the disease may have come back.

According to the study, brachytherapy was also associated with a higher rate of infections, rib fractures, fat necrosis and breast pain.

“Honestly, it was somewhat shocking to me when I got this data for the first time,” Dr. Benjamin D. Smith, an assistant professor of radiation oncology at the MD Anderson Cancer Center and lead investigator on the study, told the Times.

Brachytherapy, a treatment that is becoming increasingly popular among women with early-stage breast cancer, uses a catheter to deliver radiation directly into the cavity left after undergoing a lumpectomy. Because the radiation is delivered directly to the affected area, the treatment can be completed in a week, compared with six or seven weeks for whole breast radiation.

One weakness, however, is that the study was not a randomized trial, so the differences in outcomes could be attributed to differences in the characteristics of those who chose brachytherapy and those who chose conventional treatment. According to the Times, Dr. Smith said adjustments were made for known differences and the results still held. “It’s very hard to know from this particular study what the bottom line should be because of differences in patient populations,” Dr. Abram Recht, a radiation oncologist at Harvard and Beth Israel Deaconess Medical Center, told the Times. Still, the higher rates of complications from brachytherapy raised a note of caution, he added. Dr. Rakesh Patel, chairman of the American Brachytherapy Society, told the Times that other studies have shown that breast brachytherapy is equivalent in effectiveness to whole breast irradiation in appropriate patients. According to the Times, the National Cancer Institute is sponsoring a clinical trial comparing whole breast irradiation to partial breast irradiation, including brachytherapy, but the results will not be available for several years.
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