Feature | September 27, 2013

External Beam Radiation Therapy for Early-stage Breast Cancer Does Not Increase Mortality Risks

ASTRO External Beam Radiation Therapy Early-stage Breast Cancer Mortality Risks

September 27, 2013 — Early-stage breast cancer patients who receive external beam therapy (XRT) are not at higher risk for serious long-term side effects in the chest area, including increase in deaths from cardiac disease and secondary malignancies, according to research presented at the American Society for Radiation Oncology’s (ASTRO’s) 55th Annual Meeting.

The study utilized patient information from the National Cancer Institute’s Surveillance, Epidemiology and End Results (SEER) database. It evaluated women identified as having primary Stage T1aN0 breast cancer (tumor of 5mm or less that has not spread to the lymph nodes), who received surgery, with or without post-operative radiation therapy, between 1990 and 1997. The analysis was done to determine if XRT was associated with increased mortality due to breast cancer, secondary cancer in the chest area or cardiac conditions for these patients; only patients with breast cancer (BC) identified as the first malignancy were included. The women had a median age of 55-59 and were divided into two groups: 2,397 who received XRT after surgery, and 2,988 who did not receive XRT after surgery.

Cause of death (COD) codes were used to identify cardiac mortality, breast cancer mortality, and deaths from secondary chest cancers in order to assess overall survival (OS), breast cancer survival (BCS), second-tumor specific survival and cardiac-cause specific survival (CCS), and then compared between the XRT and non-XRT groups. The incidence of mortality was compared between the XRT and non-XRT groups utilizing the Chi-Square test; and, the relative risk (RR) and associated 95 percent confidence interval (CI) were calculated. Kaplan-Meier survival analysis and log-rank test were performed to assess OS, BCS, second-tumor specific survival and CCS.

At 10 years post-treatment, OS rates were 91.6 percent for the XRT patients and 87 percent for the non-XRT group; BCS rates were 97 percent for the XRT patients and 95.7 percent for the non-XRT group; and CCS was 96.7 percent for the XRT patients and 92.7 percent for the non-XRT group.

Analysis of the data further demonstrates that, with a median follow up of 14 years, there was no statistically significant difference in deaths from subsequent non-breast cancers in the chest area, the majority of which were lung cancers. The number of deaths from cardiac causes was not significantly higher for those patients treated with XRT for left-sided breast cancer, compared to those with right-sided breast cancer among the patient sample and time period reviewed. More women from the non-XRT group died from all causes, including cardiac causes, suggesting that those patients had worse general health conditions than the women who received radiation therapy.

“Breast conserving therapy, consisting of lumpectomy and XRT, has been an excellent approach to early breast cancer treatment, offering equivalent disease control and better cosmetic results compared to mastectomy as demonstrated by multiple randomized controlled trials in the past,” said Jason Ye, M.D., the study’s presenting author and a second-year resident in radiation oncology at Weill Cornell Medical College in New York City. “Our study’s results suggest that serious long-term side effects of radiation therapy, such as increase in deaths from cardiac disease and secondary malignancies, are rare. Radiation therapy is an integral part of early stage breast cancer treatment for those who choose to have a lumpectomy instead of a mastectomy, with its benefits likely far outweighing the potential risks in majority of the cases. The field of radiation oncology is rapidly changing, with new technology constantly being introduced that may reduce these risks further. Continued long term follow up and additional studies are needed to monitor for potential long term side effects.”

For more information: www.astro.org

Related Content

Women With Coronary Artery Wall Thickness at Risk for Heart Disease
News | Cardiac Imaging | April 25, 2019
The thickness of the coronary artery wall as measured by magnetic resonance imaging (MRI) is an independent marker for...
Philips Unveils IntelliSpace Radiation Oncology at ESTRO 2019
News | Oncology Information Management Systems (OIMS) | April 25, 2019
Philips announced IntelliSpace Radiation Oncology, an intelligent patient management solution to manage complexity,...
Accuray Launches Synchrony Motion Tracking and Correction Technology for Radixact System
Technology | Image Guided Radiation Therapy (IGRT) | April 24, 2019
Accuray announced the launch of its Synchrony motion tracking and correction technology to be used with the Radixact...
Cianna Medical featured its wire-free marker system on the exhibit floor of the breast imaging symposium in Hollywood, Fla.

Cianna Medical featured its wire-free marker system on the exhibit floor of the breast imaging symposium in Hollywood, Fla.

Feature | Breast Imaging | April 24, 2019 | By Greg Freiherr
Wires have traditionally been placed prior to lumpectomy to mark cancerous tissues in the breast.
New Study Redefines Therapeutic Dose Guidelines for Non-Small Cell Lung Cancer
News | Lung Cancer | April 23, 2019
Non-small cell lung cancer is a common cancer for both men and women. Many people who are diagnosed with this type of...
GE Healthcare showcases Senographe Pristina with its add-on-biopsy kit at the breast imaging symposium

GE Healthcare showcases Senographe Pristina with its add-on-biopsy kit at the breast imaging symposium in Hollywood, Florida. Photo by Greg Freiherr

Feature | Breast Imaging | April 23, 2019 | By Greg Freiherr
Signs of what the future may look like in women’s health dotted the exhibit floor of the...
Comparison of state Medicaid fees for radiation oncology services for breast cancer and nonradiation oncology services per the Kaiser Family Foundation Index

Fig. 1: Comparison of state Medicaid fees for radiation oncology services for breast cancer and nonradiation oncology services per the Kaiser Family Foundation Index. (Agarwal et al, Red Journal, 2019) Credit: Elsevier

News | Radiation Therapy | April 22, 2019
April 22, 2019 — A new study finds wide state
Stereotactic Radiosurgery Effective for Pediatric Arteriovenous Malformation Patients
News | Radiation Therapy | April 19, 2019
Ching-Jen Chen, M.D., of the neurosurgery department at the University of Virginia (UVA) Health System, was the winner...
In a demonstration on the exhibit floor of the SBI symposium, Koios software identified suspicious lesions in ultrasound images

In a demonstration on the exhibit floor of the SBI symposium, Koios software identified suspicious lesions in ultrasound images. Photo by Greg Freiherr

Feature | Artificial Intelligence | April 19, 2019 | By Greg Freiherr
Commercial efforts to develop...
Videos | Breast Imaging | April 18, 2019
In a keynote lecture at the Society of Breast Imaging (SBI)/American College of Radiology (ACR) 2019 Symposium, ...