THE QUESTION The standard way to administer radiation after breast cancer surgery is with an external beam of high-energy X-rays. An increasingly popular newer method is brachytherapy, which involves implanting radioactive seeds or wires in the body. How do the results compare?
THIS STUDY analyzed data on 92,735 older women (average age, 75) who had a lumpectomy to remove the cancerous tumor and then were given brachytherapy or external radiation treatment to destroy any remaining microscopic cancer cells. In the next year, postoperative complications, including infections and bleeding problems, were reported in 28 percent of the women who had brachytherapy and
17 percent of those given external radiation. Chances of having a mastectomy within five years of the original surgery were twice as great with brachytherapy treatment (4 percent vs. 2 percent for external radiation), and women whose cancer had involved lymph nodes were five times as likely to have a mastectomy if they had brachytherapy rather than external radiation. However, overall survival rates after five years were essentially the same, about 87 percent.
WHO MAY BE AFFECTED? Women with breast cancer who have a lumpectomy, sometimes called a partial mastectomy, which removes the tumor and some surrounding tissue but leaves the rest of the breast intact. For subsequent radiation, brachytherapy irradiates less breast tissue and requires a shorter span of treatment than external radiation does, but it is a surgical procedure.
CAVEATS Whether the findings apply to younger women was not studied. Study data did not indicate whether subsequent mastectomies were to treat cancer recurrences or for other reasons. As with most new technologies, results may differ depending on the experience of specific surgeons and hospitals.
FIND THIS STUDY May 2 issue of the Journal of the American Medical Association (www.jama.com).
The research described in Quick Study comes from credible, peer-reviewed journals. Nonetheless, conclusive evidence about a treatment's effectiveness is rarely found in a single study. Anyone considering changing or beginning treatment of any kind should consult with a physician.