External beam RT for early-stage breast cancer does not increase mortality risks

September 24, 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 today 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 (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, in the chest area or 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 , , 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, MD, the study's presenting author and a second-year resident in at Weill Cornell Medical College in New York City. "Our study's results suggest that serious long-term side effects of , 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."

Explore further: Long-term hormonal therapy in intermediate-risk PCa patients does not improve overall survival

More information: The abstract, "Breast Cancer (BC), Second Cancer, and Cardiac Mortality in Stage T1aN0 BC Patients with or without External Beam Radiation Therapy (XRT): NCI SEER Study," will be presented in detail during a scientific session at ASTRO's 55th Annual Meeting at 1:00 p.m. Eastern time on Tuesday, September 24, 2013.

Related Stories

Long-term hormonal therapy in intermediate-risk PCa patients does not improve overall survival

September 23, 2013
A secondary analysis of the historic RTOG 9202 prostate cancer trial examined results of men with intermediate-risk prostate cancer who had received long-term hormonal therapy after radiation therapy, and concluded that there ...

MRI right before or after surgery does not benefit women with early breast cancer

September 4, 2013
Memorial Sloan-Kettering Cancer Center study shows that the use of MRI before or immediately after surgery in women with DCIS was not associated with reduced local recurrence or contralateral breast cancer rates. The findings ...

Better survival rates seen with lumpectomy compared with mastectomy for early breast cancer

January 28, 2013
A new analysis has found that lumpectomy plus radiation for early breast cancer may provide patients with a better chance of survival than mastectomy. Published early online in Cancer, a peer-reviewed journal of the American ...

Fewer weeks of hormone therapy before radiation reduces side effects in intermediate risk PCa

September 23, 2013
A shorter course of androgen suppression therapy prior to radiation therapy, when compared to a longer course of androgen suppression therapy, yields favorable outcomes and fewer adverse effects for intermediate-risk prostate ...

Young breast cancer patients often opt for mastectomy

May 30, 2013
A new study of young women with breast cancer has found that most chose to have a mastectomy rather than a surgical procedure that would conserve the breast, researchers will report at the 49th Annual Meeting of the American ...

No long-term heart risks from breast radiation, study suggests

October 29, 2012
(HealthDay)—A new study allays concerns that early-stage breast cancer patients who receive radiation treatment might have a long-term increased risk for heart problems.

Recommended for you

Major study of genetics of breast cancer provides clues to mechanisms behind the disease

October 23, 2017
Seventy-two new genetic variants that contribute to the risk of developing breast cancer have been identified by a major international collaboration involving hundreds of researchers worldwide.

Microbiologists contribute to possible new anti-TB treatment path

October 23, 2017
As part of the long effort to improve treatment of tuberculosis (TB), microbiologists led by Yasu Morita at the University of Massachusetts Amherst report that they have for the first time characterized a protein involved ...

New study shows how cells can be led down non-cancer path

October 23, 2017
As cells with a propensity for cancer break down food for energy, they reach a fork in the road: They can either continue energy production as healthy cells, or shift to the energy production profile of cancer cells. In a ...

Proton therapy lowers treatment side effects in pediatric head and neck cancer patients

October 23, 2017
Pediatric patients with head and neck cancer can be treated with proton beam therapy (PBT) instead of traditional photon radiation, and it will result in similar outcomes with less impact on quality of life. Researchers from ...

Big Data shows how cancer interacts with its surroundings

October 23, 2017
By combining data from sources that at first seemed to be incompatible, UC San Francisco researchers have identified a molecular signature in tissue adjacent to tumors in eight of the most common cancers that suggests they ...

Symptom burden may increase hospital length of stay, readmission risk in advanced cancer

October 23, 2017
Hospitalized patients with advanced cancer who report more intense and numerous physical and psychological symptoms appear to be at risk for longer hospital stays and unplanned hospital readmissions. The report from a Massachusetts ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.