Targeted Radiation for Breast Cancer May Cause More Complications
Study found brachytherapy had higher rates of wound, skin problems than whole-breast treatment in older women
Wednesday, October 24, 2012
In older women with early stage breast cancer, the standard treatment is breast-conserving surgery, typically followed by radiation therapy to reduce the risk of cancer recurrence.
In brachytherapy, radiation sources are temporarily implanted in catheters within the site of the cancer surgery. Proponents of brachytherapy say it is better than whole-breast radiation because it reduces the amount of healthy tissue exposed to radiation.
"This treatment method seems ideal in theory, but we found it concerning that such an important clinical decision that affects so many women was being made on the basis of theory, rather than scientific evidence," study lead author Dr. Cary Gross, an associate professor of internal medicine at Yale School of Medicine, said in a Yale news release.
"Despite the absence of large randomized controlled trials comparing these two treatments, brachytherapy has become increasingly popular, in part because of a theoretically lower rate of complications," he noted.
Gross and his colleagues studied Medicare data on about 30,000 women and found that nearly 16 percent of breast cancer patients undergoing radiation therapy received brachytherapy in 2008-09. Brachytherapy rates were less than 1 percent in 2000 and 10 percent in 2006.
The researchers also found that brachytherapy was associated with a nearly 17 percent higher rate of wound and skin complications in the year after treatment, compared to whole breast radiation. The two treatments had similar rates of deep tissue or bone complications.
The findings were published in the October issue of the Journal of Clinical Oncology.
"This study highlights the importance of conducting comparative effectiveness research before a new treatment becomes widespread," Gross said. "Medicare is spending significantly more money to cover this treatment, which potentially exposes women to a higher risk of complications than the 'tried and true' whole-breast irradiation."
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