Researcher Timothy Whelan and his team at McMaster University have found that older women with early stage breast cancer do not need radiotherapy after surgery.
Women with breast cancer aged 55 or older can be treated effectively with surgery and endocrine therapy alone by demonstrating a specific biomarker pattern that identifies a subset of Luminal A, Whelan said. He presented the research at the annual meeting of the American Society of Clinical Oncology, June 7 in Chicago.
Her research team, working with the Ontario Clinical Oncology Group at Hamilton Health Sciences, found 501 patients with Luminal A breast cancer five years after surgery and found that breast cancer recurrence was only 2.3 percent without radiotherapy. This is roughly comparable to this patient’s sample with a 1.9 percent risk of developing new breast cancer in their other untreated breast.
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During this time, patients with early stage breast cancer usually undergo three to five weeks of radiotherapy courses to reduce their risk of cancer recurrence, Whelan said.
“These findings are exciting because we have identified a specific group of patients who are avoiding radiotherapy and its associated side effects and potentially turning to better medical practice around breast cancer treatment,” said Professor Whelan in the Department of Oncology. McMaster, Canadian Research Chair in Breast Cancer Research and Radiation Oncologist at Hamilton Health Sciences.
“Radiotherapy has significant early side effects, fatigue and skin irritation for several weeks after completing the course, and delayed side effects such as breast shrinkage and deformity can affect quality of life and rarely more serious complications such as heart disease and second cancer,” he said.
“Not all cancers require the same level of frequent-invasive therapy. The lowest-risk group of breast cancers exhibits a luminal A biomarker and are not particularly aggressive.”
He said the overall risk of cancer recurrence after breast conservation surgery has increased in recent years thanks to regular mammogram screening, improved surgical techniques and better systemic therapies.
Whelan said her research has been tracking patients with a luminal A mutation in breast cancer for 10 years to learn more about the effectiveness of treatment without the use of radiotherapy.
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