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

Transpara Deep Learning Software Matches Experienced Radiologists in Mammogram Reading
News | Computer-Aided Detection Software | January 12, 2018
Deep learning and artificial intelligence improves the efficiency and accuracy of reading mammograms, according to...
Fat Distribution in Women and Men Provides Clues to Heart Attack Risk
News | Women's Health | January 11, 2018
January 11, 2018 – It’s not the amount of fat in your body but where it is stored that may increase your risk for hea
Women Prefer Getting Mammograms Every Year
News | Mammography | January 09, 2018
Women prefer to get their mammograms every year, instead of every two years, according to a new study presented at the...
Planmed Clarity 2-D Digital Mammography System Receives FDA Approval
Technology | Mammography | January 08, 2018
The U.S. Food and Drug Administration (FDA) issued an approval letter for the Planmed Clarity 2-D full-field digital...
Overweight Women May Need More Frequent Mammograms
News | Mammography | January 04, 2018
Women with higher body mass index (BMI) face an increased risk of not detecting their breast tumor until it has become...
Mevion Receives 510(k) Clearance for Hyperscan Pencil Beam Scanning Proton Therapy
Technology | Proton Therapy | January 04, 2018
Mevion Medical Systems has received U.S. Food and Drug Administration (FDA) 510(k) clearance for the Mevion S250i...
Study Compares Radiosurgery and Whole-Brain Radiation in Lung Cancer Patients With Multiple Brain Metastases
News | Radiation Therapy | January 03, 2018
Although targeted therapies have produced dramatic advances in the ability to control some types of advanced lung...
About 25 percent of screening patients and 60 percent of diagnostic patients do not have prior mammograms available for comparison at the time of their examinations due to the lack of interoperability or other restrictions preventing clinicians from accessing prior exams.

About 25 percent of screening patients and 60 percent of diagnostic patients do not have prior mammograms available for comparison at the time of their examinations due to the lack of interoperability or other restrictions preventing clinicians from accessing prior exams.

Feature | Breast Imaging | January 02, 2018 | Kathryn Pearson Peyton, M.D.
Sixty million women undergo regular screening mammography in the United States, but even in the digital age, it is di
MEDraysintell Downgrades Proton Therapy Market Projection for 2030
News | Proton Therapy | January 02, 2018
MEDraysintell recently downgraded its projection for proton therapy rooms expected to be operational in 2030 from 1,200...
Imagio Opto-Acoustic Breast Imaging System Helps Differentiate Tumor Subtypes
News | Oncology Diagnostics | January 02, 2018
Seno Medical Instruments Inc. (Seno Medical) recently reported data from their clinical study demonstrating that its...
Overlay Init