Most Breast Cancer Patients Don't Need Radiation

Many women with early-stage breast cancer may be able to skip radiation after surgery without affecting their long-term survival, a new study suggests. The large clinical trial, published Wednesday in the New England Journal of Medicine, followed over 1,600 women with early-stage breast cancer, who were considered at intermediate risk, for nearly a decade. They'd been treated with some combination of mastectomy, lymph-node surgery, and modern anti-cancer drugs, with a small portion also receiving chemotherapy, per the New York Times. Half the women received radiation after surgery; the other half did not.

After a median follow-up of 9.6 years, survival rates were nearly identical: 81.4% for those who had radiation and 81.9% for those who did not. Radiation also did not affect the time women lived without a recurrence or whether the cancer spread elsewhere in the body. While radiation did reduce the risk of cancer returning in the chest wall, the number of recurrences in both groups was low. Just 20 of 799 women in the non-radiation group (2.5%) experienced chest wall recurrences, compared to nine of 808 in the radiation group (1.1%), per a release.

The findings support a growing trend of using radiation therapy less often in lower-risk patients, as chemotherapy and other treatments have become more effective at preventing recurrence. "We've now shown that with contemporary anti-cancer treatments, the risk of recurrence is very, very low—sufficiently low to avoid radiotherapy in most patients," said lead investigator Dr. Ian Kunkler, per the Times. However, he and his colleagues note that radiation—which comes with side effects including skin changes, swelling, and, in rare cases, lung inflammation—may still be appropriate for higher-risk patients.