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For Release: October 23, 2000
Younger Breast Cancer Patients Benefit from Radiation Boost
Breast cancer patients under the age of 50 who choose lumpectomy and radiation therapy should receive an additional boost of radiation as part of their treatment, a new study shows.
The study of 5,569 women found that a 16 Gy boost of radiation given at the end of five weeks of radiation treatment can dramatically reduce the chance that cancer will return at the site of the original tumor, says Harry Bartelink, M.D., Ph.D., of the Netherlands Cancer Institute in the Netherlands. Dr. Bartelink presented the study at the American Society for Therapeutic Radiology and Oncology annual meeting on October 23 in Boston, MA. The patients in the study had stage I or II disease with tumors up to 5 cm in diameter.
"We saw a 48 percent reduction in local recurrence rates for women ages 41 - 50 who had the radiation boost," says Dr. Bartelink. The boost provided an even greater benefit for women under 40. "This group saw a 54 percent reduction in local recurrence rates," he says. There were 1,334 patients in the study who were between the ages of 41 - 50 and 449 patients under the age of 40, notes Dr. Bartelink.
Currently some doctors recommend the boost dose of radiation, but others don't, says Dr. Bartelink. Based on this large study, conducted in 11 different countries across Europe, "it is clear to us that younger patients should be given a boost," he says.
The boost radiation did cause a slight change in the breast, however, the cosmetic results remain superior to surgery, says Dr. Bartelink.
There had been some concern about increased side effects to the heart and lung, says Dr. Bartelink, but "we found no increase in side effects," he says.
It is too early in the study to see if the boost increases survival, says Dr. Bartelink. The study has only followed patients for five years; another five years is needed. It stands to reason though that a reduction in local recurrence rates will lead to improved survival, he says. It is important to note that the five-year survival rate for all patients in the study was 91 percent, he says.
There was an added benefit to doing the study, says Dr. Bartelink. "The study set the standard for better quality breast cancer treatment," he says. The 32 radiation therapy departments in the 11 participating countries now have strict quality assurance procedures in place which help ensure that patients who are treated there - regardless if they are at a major academic center or a smaller community center - are receiving quality care," he says.
The standardization of care in these European centers was similar to what occurred in the United States when the National Surgical Adjuvant Breast Program (NSABP) started randomized breast treatment protocols in the late 1970s.
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