Shorter breast cancer course 'as effective'

Shorter treatment regimes may lessen patients' burden

A short course of radiation therapy after a breast cancer operation is just as effective as a longer course, Canadian researchers have found.

They looked at women who had had breast lumpectomies.

Giving women a course of radiation after the operation is known to substantially reduce the risk of the breast cancer returning.

It will have important quality-of-life benefits with respect to convenience and less time away from home and work

Dr Timothy Whelan

But doctors are divided about how long the course should be.

In the UK and Canada, large doses of radiation are given to patients over a short period of time.

But in the US, it is given in smaller doses over several weeks.

Intensive treatment

Researchers from the Hamilton Regional Cancer Centre in Ontario looked at 1,234 women who had undergone lumpectomies for invasive breast cancers that had not spread to the lymph nodes.

They were randomly assigned either to receive a short, intensive 22 day course, or less intensive treatment over 35 days.

The women were re-examined almost six years later.

It was found that the shorter course did not lead to an increased recurrence of breast cancer.

Survival rates at five years were 97.2% for that group, compared to 96.8% in the women receiving the longer course of treatment.

There was no difference in the numbers of women who were free of breast cancer at the time when they were followed up, or on overall survival.

Neither did the intensive treatment result in a worse cosmetic outcome for the appearance of the women's breasts.

Toxic effects from radiation, such as damage to the skin, were rare in both groups.

Quality-of-life

Writing in the Journal of the National Cancer Institute, the researchers led by Dr Timothy Whelan, said the shorter treatment schedule would lessen the burden for women who may also be receiving chemotherapy.

They added: "And it will have important quality-of-life benefits with respect to convenience and less time away from home and work."

In an editorial in the journal, Dr Carolyn Sartor and Dr Joel Tepper, of the University of North Carolina School of Medicine, ask whether this study sets a new standard for using radiation therapy in early-stage breast cancer.

They say it may, but that this study's results only apply to women who have small tumours that have been completely removed.

For them, they suggest radiation therapy could be made more convenient and less expensive.