Older women with breast cancer experience more complications with brachytherapy than whole breast irradiation
Women with early breast cancer typically receive a lumpectomy followed by either whole breast irradiation (WBI) or brachytherapy. Brachytherapy is a means of delivering radiation using an implanted radioactive source. Compared with WBI, it irradiates less breast tissue and requires a much shorter course of treatment. As many as 10 percent of older women with breast cancer are now treated with brachytherapy, and at least 50,000 have been treated to date in the United States. Older women receiving brachytherapy are more likely to have had a subsequent mastectomy, post-operative complications, and a higher incidence of breast pain, according to a new study. However, there was no difference in survival between the two groups of women.
The researchers retrospectively studied women aged 67 years or older with invasive breast cancer who underwent a lumpectomy and subsequently received either WBI (85,783) or brachytherapy (6,962). They were initially diagnosed between 2003 and 2007 and followed for up to 5 years. The researchers caution that although their results await validation in a prospective study, they should also prompt caution over widespread application of breast brachytherapy outside of a research setting. Their study was supported by the Agency for Healthcare Research and Quality (HS18535).
See "Association between treatment with brachytherapy vs whole-breast irradiation and subsequent mastectomy, complications, and survival among older women with invasive breast cancer," by Grace L. Smith, Ph.D., Ying Xu, M.D., Thomas A. Bucholz, M.D., and others in the May 2, 2012, Journal of the American Medical Association 307(17), pp. 1827-1837.