10-Year Study Follow-up on Breast Irradiation Techniques for Early-Stage Breast Cancer

By: Joshua D. Madera, MS
Posted: Monday, May 15, 2023

Accelerated partial-breast irradiation using multicatheter brachytherapy is a comparable and efficacious alternative to standard whole-breast irradiation for patients with early-stage breast cancer after breast-conserving surgery, according to the 10-year results of the GEC-ESTRO phase III trial, published in The Lancet Oncology. In addition, accelerated partial-breast radiotherapy modality was associated with a decreased risk of late side effects, reported Vratislav Strnad, MD, PhD, of the University Hospital Erlangen and Comprehensive Cancer Center Erlangen-EMN, Germany, and colleagues.

“[Accelerated partial breast irradiation] using multicatheter brachytherapy should be considered as an attractive standard treatment option for patients with low-risk early breast cancer opting for breast-conserving therapy and postoperative radiotherapy,” explained Dr. Strnad and his collaborators.

From 2004 to 2009, a total of 1,328 female patients with early invasive breast cancer or ductal carcinoma in situ were recruited for the study. All patients had previously received breast-conservation therapy. Patients were randomly assigned to receive whole-breast irradiation (n = 673) or accelerated partial-breast irradiation (n = 655).

At a median follow-up of 10.4 years, recurrence rates of 1.6% and 3.5% were identified in patients who received whole-breast irradiation and accelerated partial-breast irradiation, respectively, with just a 1.9% difference between treatment groups. Moreover, grade 1 and 2 treatment-related adverse effects were identified in 60% of patients who received whole-breast irradiation and 67% of patients who received accelerated partial-breast irradiation. Treatment-related grade 3 adverse events were reported less frequently with accelerated partial-breast irradiation (1%) as compared with whole-breast irradiation (4%). Furthermore, the most common grade 3 adverse event noted by patients was fibrosis.

“Future perspectives include further exploration of the possibilities of more treatment de-escalation for patients with early breast cancer—not only in terms of local therapy but particularly the possibilities of de-escalation or even omission of systemic treatments,” the authors wrote.

Disclosure: For full disclosures of the study authors, visit thelancet.com.

The Lancet Oncology

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