Researchers say the new treatment option is effective and less complex for some women with early stage breast cancer.
For most women with early stage breast cancer, treatment options have been limited.
Either remove the breast via mastectomy, or remove the tumor and irradiate the entire breast for weeks.
But new research indicates that, for some women, a third option can be effective — one that takes just five days.
Partial breast irradiation, in which treatment is concentrated on a small area where the tumor was removed, is considerably faster than, and similarly effective as, whole breast radiation.
A 10-year follow-up after treatment found that women with whole breast irradiation experienced a 3.9 percent rate of recurrence, while partial breast irradiation’s rate of recurrence was 4.5 percent — a difference of less than 1 percentage point.
Partial radiation is seen as a potential alternative therapy for women with ductal carcinoma in situ (DCIS) and early stage breast cancer that’s deemed low risk.
A team of researchers led by Dr. Julia White, co-principal investigator of the data and head of breast radiation oncology at The Ohio State University Comprehensive Cancer Center, is scheduled to present their data at the American Society of Clinical Oncology (ASCO) annual meeting early next month.
White told Healthline that the findings show progress in the way that breast cancer is treated — and could open the door to more women getting treatment.
Researchers noted that when breast cancer treatment fails and the cancer recurs, it generally comes back in the area where the tumor used to lie.
“That really begged the question of whether you really need to irradiate the whole breast,” White said. “Maybe you could just irradiate where the tumor came out of the breast, make it simpler and more convenient, and maybe more women get treatment and don’t feel compelled to undergo a mastectomy.”
The quicker option could also benefit women who don’t live near irradiation services.
White described working in parts of the country where irradiation services aren’t readily available. For a woman in one of these areas, it can be tough to make plans for weeks of therapy.
“Partial breast irradiation was really born out of a pragmatic way of getting radiation done to allow better access to it, so that more women who want it and who otherwise wouldn’t get it could get breast irradiation with a shorter period of time,” she said.
Dr. Lauren S. Cassell, chief of breast surgery at Lenox Hill Hospital in New York, told Healthline that this quicker form of therapy holds some advantages for suitable patients.
“This allows the patient to get through the process in a short period of time, which is appealing to most women, particularly if they do not have easy access to a radiation facility or have very busy lives,” Cassell told Healthline.
“It also leaves open the potential for another round of radiation should they develop cancer in another portion of the breast, which is not possible with whole breast irradiation,” she added.
Another advantage to this form of therapy is that it’s virtually as effective, but less involved, than some of the alternatives.
A mastectomy in particular, in which one or both breasts is removed, is an invasive form of treatment.
“Basically, there’s no advantage in overall survival with a mastectomy if the tumor is amenable to breast conservation — a lumpectomy or partial mastectomy,” explained Cassell.
“Some patients emotionally cannot live with breast conservation and having to be followed with mammograms, sonograms, and sometimes MRIs. Thus, they prefer to undergo bilateral mastectomies, usually with reconstruction,” she added.
Cassell points out that recent trends in the treatment of breast cancer tend to revolve around things becoming more personalized: more patient-specific treatment, less radiation, less chemotherapy, more targeted drugs, and expanded genetic testing.
“The question becomes: Are we able to do less for certain subsets of patients without compromising outcomes?” she said. “This has been apparent in the field of radiation therapy as well.”
While the technology already exists to roll out partial breast irradiation as an alternative treatment, this is easier said than done.
White points out that for about three decades conventional medical wisdom has agreed that getting the tumor removed, followed by radiation, is an effective treatment.
“There must have been 20 randomized trials looking at that. But in all the cases, it was whole breast irradiation,” White said. “Sometimes when there’s such an established treatment like this, you need a big trial to get people to let go of what they’re comfortable doing and embrace something like partial breast irradiation.”
For women with early stage breast cancer, treatment options have traditionally been limited to either removing the entire breast or removing the tumor and irradiating the whole breast.
Researchers have shown that a third option — one that removes the tumor but irradiates only the area of the tumor was removed — is nearly as effective. The whole process only takes five days.
The new option represents a de-escalation in therapy with almost identical health outcomes.
Researchers are hoping that more hospitals and radiation facilities will begin offering it as an option.
Partial breast irradiation doesn’t work for all patients with stage 0, 1, or 2 of the disease, but it was effective for women with DCIS and early stage breast cancers.