A new study reports that 2/3 of women who have lumpectomies for breast cancers are receiving radiation treatment that last nearly twice as long as necessary.
Radiation is used after women have lumpectomies because it reduces the odds that another cancer will arise in the breast and it improves the chances of survival.
The longer treatment lasts five to seven weeks. However, multiple rigorous studies and guidelines from a leading radiology society conclude that three to four weeks or more intense radiation is just as effective.
Studies have found that women tend to prefer the shorter course of radiation, which also happens to be less expensive.
Because it takes time to change ingrained medical practices, although 60 to 7% of women with breast cancer have lumpectomies, relatively few are getting the shorter treatment. The reluctance to change also stems from the fact that the procedure has been used for decades and the new one offers no additional medical benefit.
Although shorter treatment may have no medical benefit, it does have over all beneficial attributes such as saving time for patients and money for the health care system and insurers.
The recent study was published Wednesday in JAMA, the Journal of the American Medical Association. In the study, two doctors analyzed data from 14 commercial insurance plans involving 15,643 women who had their breasts irradiated after lumpectomies.
The researchers considered two categories of women who had radiation therapy and asked how many got the short course. One group closely matched women in the previous randomized studies that evaluated the conventional treatment versus the shorter one. These women were over 50 years old and have early-stage cancers. Practice guidelines published in 2011 recommend the shorter radiation therapy for this category of women.
The other group was a set of younger women that had had prior chemotherapy or had cancer cells in their lymph nodes, indicating a more advanced cancer. The practice guidelines neither endorse nor discourage the shorter therapy for these women.
The results from the study contradicted years of practice in the field. In the 1970s and 1980s oncologist found that shorter and more intense therapy burned women’s skin, scarred their breasts and made their breasts shrivel and shrink over the ensuing decade.
However, improved equipment and methodology demonstrated that cosmetic results were just as good with the shorter treatment.