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Targeted Radiation for Breast Cancer May Be Overused: Study
Date:12/19/2011

ing to ASTRO criteria.

Only about a third (32 percent) of patients would have been considered suitable under ASTRO's recommendations, the study authors said.

Use of brachytherapy rose from less than 1 percent in 2000 to almost 7 percent in 2007, but this varied greatly between geographical regions, the researchers noted.

For instance, women in urban areas were more likely to get brachytherapy than women in rural areas, which is surprising given that rural women would have the most to benefit from the convenience.

And white women were more likely to get brachytherapy than black women if they were considered "cautionary" or "unsuitable."

It's unclear what accounts for the variation or for the rise in numbers, although the authors did postulate that reimbursement patterns may play a role. Medicare started reimbursing for brachytherapy in 2004.

The main drawback of this study, the authors acknowledged, is that the data was gathered before the ASTRO guidelines were published.

Dr. Eric Horwitz, M.D., chair of radiation oncology at Fox Chase Cancer Center in Philadelphia, agreed that brachytherapy is "not for everybody" but that "it's an excellent technique if used on the right patients."

But who is the right patient? Generally people with smaller, localized tumors, he said.

Still, in the absence of long-term data, Hattangadi recommends that women getting treatment for early-stage breast cancer have a "thorough discussion with their physicians on the pros and cons of the approach."

The findings come just a week after presenters at a national conference found that women who had brachytherapy had double the rate of mastectomy later on compared with women who got whole breast irradiation. That study was led by Dr. Benjamin Smith of M.D. Anderson Cancer Center in Houston and presented at the San Antonio Breast Cancer Symposium

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