According to a recent study, older women with early-stage hormone-receptor positive breast cancer only gain modest benefits from radiotherapy. The findings were published in the journal Lancet Oncology, entitled, “Management of elderly patients with breast cancer: updated recommendations of the International Society of Geriatric Oncology (SIOG) and European Society of Breast Cancer Specialists (EUSOMA).”
Best clinical practice in oncology assumes that older women with early-stage hormone-positive breast cancer should have their tumors removed by surgery, and subsequently are offered radiotherapy and hormonal treatment. However, there is limited evidence of the benefits of radiotherapy in this patient population.
As such, a research team led by Professor Ian Kunkler from the Edinburgh Cancer Research Centre at the University of Edinburgh designed an international randomized controlled trial examining a population of 1,326 women aged over 65 years with a diagnosis of early-stage hormone-receptor positive breast cancer. Patients had their tumors removed by surgery and did not have any metastasis to the lymph nodes under the arm. Half of the patients were assigned to a study group where they were given radiotherapy and treatment with hormones. The other half were given only the hormonal treatment.
After five years of follow-up, the researchers observed that 96% of the women from both study groups survived. Furthermore, women did not die as a consequence of their breast cancer. In addition, the researchers found that approximately 1% of the patients who were given radiotherapy had cancer relapse, compared to 4% of the patients that only received hormonal treatment.
These results indicate that older women with early breast cancer who undergo tumor removal surgery and hormonal treatment gain only very modest benefit from radiotherapy. “This makes omission of radiotherapy an option for selected older patients,” Professor Ian Kunkler said in a news release.
Findings from this study strongly suggest that some older women with breast cancer could avoid radiotherapy without reducing their possibilities of survival, minimizing their exposure to the adverse effects caused by radiation, such as fatigue and cardiac damage.
“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,” Professor Ian Kunkler added.