Study: Elderly Breast Cancer Patients Can Opt for No Radiotherapy

According to new research, radiotherapy does not increase the survival chances of elderly breast cancer patients. The present standard of care, which consists of hormone therapy, breast-conserving surgery, and radiotherapy, did not change the death rates for patients 65 years of age or older, according to researchers.

Additionally, it was discovered that radiotherapy had no impact on the chance of metastasis, or secondary cancers. The probability of cancer returning did, however, slightly decrease, but it is still within the range that is clinically acceptable.

One of the first long-term clinical trials for older breast cancer patients, the 10-year study showed radiotherapy can be safely avoided when treating those over 65 with early-stage breast cancer.

No matter the patient’s age, early breast cancer is typically treated with breast-conserving surgery, sometimes known as a lumpectomy, radiation, and hormone therapy to lower the likelihood of cancer returning to the breast.

At least 50% of individuals with the illness are 65 years of age or older. There haven’t been many clinical trials with elderly patients, despite the fact that radiotherapy increases their burden by causing side effects like cardiac issues and secondary tumors.

With 1,326 elderly breast cancer patients, researchers from the University of Edinburgh and the Western General Hospital in Edinburgh conducted the PRIME II randomized-clinical trial to determine whether radiation is required in addition to a lumpectomy and hormone therapy.

The patients had “low risk” breast cancer, which is defined as a tumor that is less than 3 cm in size, does not include the lymph nodes beneath the armpit, and is likely to respond to hormone therapy. The patients were 65 years of age or older.

A breast-conserving procedure and at least five years of hormone therapy were recommended for each participant. Following surgery, radiation was given to the randomly chosen half of the group for an additional three to five weeks.

Patients were evaluated during yearly clinic visits and by breast imaging.

The research team discovered that, compared to patients treated without radiotherapy, those who had radiotherapy had a 0.9 percent lower risk of developing cancer in the treated breast after 10 years. Despite this variation in recurrence rates, both fall within the permitted range per current therapeutic recommendations.

Between the two groups, there was no difference in overall survival, and the majority of fatalities were brought on by diseases other than breast cancer.

The New England Journal of Medicine has published the findings.

Professor Ian Kunkler, Professor of Clinical Oncology at the University of Edinburgh, said, “Radiotherapy can place a heavy burden on patients, particularly older ones. Our findings will help clinicians guide older patients on whether this particular aspect of early breast cancer treatment can be omitted in a shared decision-making process, which weighs up all the risks and benefits.”

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