Navigation Links
Study finds side effects, complications, mastectomy more likely after partial breast irradiation
Date:12/6/2011

San Antonio, TX - Accelerated partial breast irradiation (APBI) brachytherapy, the localized form of radiation therapy growing increasingly popular as a treatment choice for women with early-stage breast cancer, is associated with higher rate of later mastectomy, increased radiation-related toxicities and post-operative complications, compared to traditional whole breast irradiation (WBI), according to researchers from The University of Texas MD Anderson Cancer Center.

The retrospective study was presented in the CTRC-AACR San Antonio Breast Cancer Symposium's press briefing by Benjamin Smith, M.D., assistant professor in the Department of Radiation Oncology, and in the meeting's scientific session by Grace Smith, M.D., Ph.D., a resident in MD Anderson's Department of Radiation Oncology and the study's first author.

"Our study compared the two radiation therapy techniques available to women with early-stage breast cancer. We found that women treated with accelerated partial breast irradiation therapy have a two-fold increased risk for subsequent mastectomy, most likely because of tumor recurrence or local complications, as well as an increased risk for post-operative and radiation-related complications," said Ben Smith, the study's senior author.

There are numerous types of APBI; the MD Anderson study only looked at the brachytherapy technique, in which a form of radiation treatment involving insertion of a catheter containing a radioactive source to kill breast cancer cells that may remain after lumpectomy surgery. A specialized catheter is surgically inserted into the cavity left behind after tumor removal. APBI brachytherapy is performed a few weeks after a lumpectomy, twice daily over a course of five to seven days.

APBI brachytherapy has grown in popularity over the past decade, since earlier studies showed generally low cancer recurrence rates, though most prior studies have not directly compared the outcomes of APBI brachytherapy to traditional radiation therapy, explained Ben Smith.

The first commercially-available single catheter to deliver partial breast irradiation was approved by the FDA in 2002, escalating APBI's use, said Ben Smith.

The MD Anderson study was based on analysis of claim forms filed by 130,535 Medicare beneficiaries nationwide, who were diagnosed with cancer between 2000 and 2007.

"In our study of Medicare patients, we found a consistent increase in APBI brachytherapy, from less than 1 percent in 2000 to 13 percent in 2007. It's our guess that this trend has continued," said Smith.

There are benefits to the practicality APBI offers women, noted Ben Smith.

"For whole breast irradiation, the standard treatment time is between five and seven weeks, but studies have shown that some women experience delays or have obstacles completing their course of radiation. Treatment delays and incompletion are known to increase the risk of cancer recurrence in the breast. APBI brachytherapy is attractive because it has the potential to address those issues, because treatment only lasts one week."

However, it's also an invasive procedure with the greater potential for side-effects that are not associated with a non-invasive therapy, such as WBI, noted Smith.

For the retrospective population-based study, the MD Anderson team used Medicare claims to examine the treatment history of 130,535 women age 66 and older diagnosed with early-stage, invasive breast cancer between 2000 and 2007. All of the women were treated with breast-conserving surgery followed by either APBI, delivered by brachytherapy, or traditional radiation therapy.

The researchers analyzed for effectiveness of radiation (defined as the need for a later mastectomy), post-operative complications (infectious and non-infectious), and post-radiation complications (breast pain, fat necrosis and rib fracture).

At five years, the incidence of mastectomy was statistically significantly higher in the APBI brachytherapy-treatment group compared to that of the WBI, 4 percent and 2.2 percent, respectively. APBI brachytherapy was also found to be associated with a higher incidence of acute and late toxicities, compared to those of WBI - infectious complications, 16 and 10 percent, respectively; non-infectious complications, 16 percent and 8 percent, respectively; - and post-radiation complications - five-year incidence of rib fracture, 4 and 4 percent, respectively; fat necrosis, 9 and 4 percent, respectively; and breast pain, 15 percent and 12 percent, respectively.

The researchers note the study's limits, including that it was not randomized, the relatively-short follow up of patients and limited details regarding tumor characteristics were available.

Given the findings, communication between the patient and her physician is paramount so that a woman with breast cancer can make an informed, personalized decision, said Thomas A. Buchholz, M.D., professor and head of the Division of Radiation Oncology at MD Anderson.

"This is a very important, well-designed study in a large cohort of patients and provides the first comparison of these two popular radiation techniques after breast-conserving surgery," said Buchholz, also an author on the study. "It's important to note that in both groups, we found a relatively low risk of recurrence. Still, we have a responsibility to discuss potential risks and benefits with our patients, while we await definitive results from randomized trials."

National randomized trials comparing APBI brachytherapy to WBI are ongoing. MD Anderson will continue offering APBI to interested patients in the context of ongoing institutional and multi-institutional clinical protocols, says Buchholz.


'/>"/>

Contact: Laura Sussman
lsussman@mdanderson.org
832-264-8893
University of Texas M. D. Anderson Cancer Center
Source:Eurekalert

Related medicine news :

1. Despite Treatment, Employees with Depression Generate Higher Absentee Costs, According to Thomson Reuters Study
2. American Council on Exercise (ACE) Study Reveals Kettlebells Provide Powerful Workout in Short Amount of Time
3. TV drama can be more persuasive than news program, study finds
4. Study carried out into biological risks of eating reptiles
5. Neuroimaging study may pave way for effective Alzheimers treatments
6. Study finds racial gaps continue in heart disease awareness
7. Luth Researchs IndicatorEDG(TM) Study Finds Americans Hopes of Achieving Their Dreams Are Fading
8. First blinded study of venous insufficiency prevalence in MS shows promising results
9. Soothing infants with food focus of childhood obesity study
10. People with anxiety disorder less able to regulate response to negative emotions, study shows
11. American Heart Association Rapid Access Journal Report: Study Finds Racial Gaps Continue in Heart Disease Awareness, Low Knowledge of Heart Attack Warning Signs Among Women
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:12/2/2016)... ... December 02, 2016 , ... On Dec. 2, 2016, CURE® magazine will ... Diego honoring the 2016 MPN Heroes—eight individuals who have made a difference in the ... beyond the standard of care, demonstrating leadership within the MPN community and/or a commitment ...
(Date:12/2/2016)... ... December 02, 2016 , ... More than 100 business, civic, ... to attend the UNCF Dothan-Wiregrass Mayor’s Luncheon Dec. 9, 2016. This inaugural event, ... and operating support to UNCF-member institutions, including Miles College, Oakwood University, Tuskegee University, ...
(Date:12/2/2016)... ... December 02, 2016 , ... ... launch of its 60-day free trial program for all of the company’s desktop ... offer a truly hassle free experience. , FlexiSpot’s unique desktop risers use an ...
(Date:12/2/2016)... ... 2016 , ... The annual time frame to change Medicare health and prescription ... December 7th. Currently-enrolled Medicare beneficiaries who are looking to switch from their current plan ... to make changes during this period order for their new policy to go into ...
(Date:12/2/2016)... ... December 02, 2016 , ... With the number of pain ... an injury, patients must find the one that works for them. When an inventor ... a machine that worked and decided to share it with others. , He developed ...
Breaking Medicine News(10 mins):
(Date:12/2/2016)... In the first ever attempt to include ... from C. sativa, the Hebrew University in Jerusalem, the ... II , the Universita` del Piemonte Orientale and Phytoplant ... and unified inventory of phytocannabinoids of different botanical origin. ... remarkable chemical and structural diversity of phytocannabinoids. As a ...
(Date:12/2/2016)... bioLytical Laboratories, ein Weltführer bei schnellen Tests für Infektionskrankheiten, hat sein ... eingeführt. Continue Reading ... ... , ... ) bioLytical wurde durch die Clinton Health Access ...
(Date:12/2/2016)... N.J. , Dec. 2, 2016   CytoSorbents ... immunotherapy leader commercializing its European Union approved CytoSorb ... and cardiac surgery patients worldwide, announced that Dr. ... the 9th Annual LD Micro Main Event ... , 2016 at the Luxe Sunset Boulevard Hotel in ...
Breaking Medicine Technology: