Thousands of women with breast cancer could be spared weeks of radiotherapy after scientists discovered a new targeted approach, taking a fraction of the time, is just as effective.
A five-day course of partial breast irradiation is far less gruelling than traditional radiotherapy, which bathes the whole breast and takes up to six weeks of daily sessions.
A ten-year trial of the targeted approach has found it is just as effective as the traditional technique.
And experts say the less aggressive method is likely to come with fewer side effects such as scarring, sensitivity and a change in breast appearance.
A five-day course of partial breast irradiation is far less gruelling than traditional radiotherapy, which bathes the whole breast and takes up to six weeks of daily sessions
More than 38,000 women undergo radiotherapy for breast cancer in England each year.
The procedure is given after women have a tumour surgically removed, and is designed to eradicate all remaining cancer cells to ensure the cancer does not return.
The traditional technique involves daily radiotherapy sessions in hospital – Monday to Friday, five days a week – for between three and six weeks, something most women describe as a huge burden.
The trial, of 520 women with breast cancer in Italy, involved comparing the traditional, whole breast approach involving 30 days of radiation, to the more modern, partial radiation approach done over five days.
All the women were then monitored for ten years after treatment.
The researchers found no difference in rates of cancer recurrence with the less aggressive approach – suggesting thousands of women could be safely spared the huge burden of extended treatment.
Researcher Dr Icro Meattini of the University of Florence said: ‘Postoperative radiation still represents a mainstay of adjuvant treatment for breast cancer, able to significantly reduce the local relapse occurrence rate.’
The study showed that after 10 years, 3.3 per cent of patients in the partial radiation group had recurrence of breast cancer, compared to 2.6 per cent in the group that received whole breast treatment.
The researchers said the marginal difference was not statistically significant.
Overall survival at the 10-year mark was also very similar between the two groups – 92.7 per cent for the women who had received partial radiation and 93.3 percent for the women who received whole breast treatment.
Dr Meattini, presenting his results at the San Antonio Breast Cancer Symposium in Texas, said: ‘Accelerated partial breast irradiation can produce excellent disease control.
‘In well-selected cases, there is no difference in patients’ outcomes whether they are treated with accelerated partial breast irradiation or whole breast irradiation,’ he said.
‘A once-daily regimen of external accelerated partial breast irradiation might also produce an improved quality of life, with less toxicity, and can potentially reduce the overall treatment time.
‘Partial breast irradiation is one of the primary examples of effective de-escalation of treatment in breast oncology,’ Dr Meattini added.
‘For many patients, partial breast irradiation may be an optimal choice that is cost-effective, safe, and efficacious.’
His study did not report the different side effects between the two treatments, but he said the partial approach may also be less likely to cause cosmetic changes and is less expensive to administer.
Previous research by Cambridge University suggested partial breast irradiation came with fewer side effects such as hardening of tissue, sensitivity and a build-up of fluid.
WHAT IS BREAST CANCER, HOW MANY PEOPLE DOES IT STRIKE AND WHAT ARE THE SYMPTOMS?
Breast cancer is one of the most common cancers in the world. Each year in the UK there are more than 55,000 new cases, and the disease claims the lives of 11,500 women. In the US, it strikes 266,000 each year and kills 40,000. But what causes it and how can it be treated?
What is breast cancer?
Breast cancer develops from a cancerous cell which develops in the lining of a duct or lobule in one of the breasts.
When the breast cancer has spread into surrounding breast tissue it is called an ‘invasive’ breast cancer. Some people are diagnosed with ‘carcinoma in situ’, where no cancer cells have grown beyond the duct or lobule.
Most cases develop in women over the age of 50 but younger women are sometimes affected. Breast cancer can develop in men though this is rare.
The cancerous cells are graded from stage one, which means a slow growth, up to stage four, which is the most aggressive.
What causes breast cancer?
A cancerous tumour starts from one abnormal cell. The exact reason why a cell becomes cancerous is unclear. It is thought that something damages or alters certain genes in the cell. This makes the cell abnormal and multiply ‘out of control’.
Although breast cancer can develop for no apparent reason, there are some risk factors that can increase the chance of developing breast cancer, such as genetics.
What are the symptoms of breast cancer?
The usual first symptom is a painless lump in the breast, although most breast lumps are not cancerous and are fluid filled cysts, which are benign.
The first place that breast cancer usually spreads to is the lymph nodes in the armpit. If this occurs you will develop a swelling or lump in an armpit.
How is breast cancer diagnosed?
- Initial assessment: A doctor examines the breasts and armpits. They may do tests such as a mammography, a special x-ray of the breast tissue which can indicate the possibility of tumours.
- Biopsy: A biopsy is when a small sample of tissue is removed from a part of the body. The sample is then examined under the microscope to look for abnormal cells. The sample can confirm or rule out cancer.
If you are confirmed to have breast cancer, further tests may be needed to assess if it has spread. For example, blood tests, an ultrasound scan of the liver or a chest x-ray.
How is breast cancer treated?
Treatment options which may be considered include surgery, chemotherapy, radiotherapy and hormone treatment. Often a combination of two or more of these treatments are used.
- Surgery: Breast-conserving surgery or the removal of the affected breast depending on the size of the tumour.
- Radiotherapy: A treatment which uses high energy beams of radiation focussed on cancerous tissue. This kills cancer cells, or stops cancer cells from multiplying. It is mainly used in addition to surgery.
- Chemotherapy: A treatment of cancer by using anti-cancer drugs which kill cancer cells, or stop them from multiplying
- Hormone treatments: Some types of breast cancer are affected by the ‘female’ hormone oestrogen, which can stimulate the cancer cells to divide and multiply. Treatments which reduce the level of these hormones, or prevent them from working, are commonly used in people with breast cancer.
How successful is treatment?
The outlook is best in those who are diagnosed when the cancer is still small, and has not spread. Surgical removal of a tumour in an early stage may then give a good chance of cure.
The routine mammography offered to women between the ages of 50 and 70 mean more breast cancers are being diagnosed and treated at an early stage.
For more information visit breastcancercare.org.uk or www.cancerhelp.org.uk