In the first study evaluating patient-reported cosmetic outcomes in older women with breast cancer, MD Anderson researchers found that less radiation was associated with improved cosmetic satisfaction long-term. However, reduced radiation was also associated with a slightly increased risk of disease recurrence.
Like younger patients, older women with early-stage breast cancer have a number of treatment options, including: lumpectomy and whole breast irradiation, lumpectomy plus brachytherapy, lumpectomy alone, mastectomy without radiation, and mastectomy plus radiation. However, cosmetic and other quality-of-life outcomes associated with these treatments have not been compared in this age population.
“There’s very little in the literature about how older patients report their outcomes – either they were not included in previous studies, or were not asked about their cosmetic satisfaction. With our study, we wanted to survey women to better understand their long-term cosmetic satisfaction, and compare satisfaction across local therapy strategies,” says Cameron Swanick, a Radiation Oncology resident who led the trial.
The study builds on research published in 2012 by Benjamin Smith, M.D., which found that accelerated partial breast irradiation (APBI) brachytherapy is associated with a higher rate of later mastectomy, increased radiation-related toxicities and post-operative complications, compared to traditional whole-breast irradiation.
“We need treatment that is gentler than whole breast radiation, but provides broader of coverage than brachytherapy,” says Smith. “There are plenty of hints in the literature that indicate there’s a happy medium in between these two treatments, and that’s probably the sweet spot for many breast cancer patients.”