For Breast Cancer Care, Radiation of Whole Breast May Be Best

Study finds poorer outcomes with localized, partial-breast approach

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Brachytherapy involves "placing a catheter that will be in the patient's breast for up to two weeks that could allow bacteria to enter the skin and cause an infection," he explained.

There was no statistical difference between the five-year survival rate associated with brachytherapy (87.66 percent) and whole-breast radiation (87.04 percent). Breast cancer survival rates are not as much of a concern in this older population as improving the rate of breast preservation and decreasing the likelihood of local recurrence, study author Smith noted.

"The study by Smith and his colleagues will not change how I practice brachytherapy," Goyal said. "I will inform my patients of what the study found and that there was a higher rate of mastectomy with brachytherapy, but that it is not clear if it was due to tumor recurrence."

For some patients, a greater possibility of having a second procedure and a catheter for brachytherapy are enough to make them steer away from this option, Goyal said.

In this case, another form of partial radiation called external beam radiation, which is more common than brachytherapy and involves an external radiation source directed more locally at the lumpectomy area, can provide similar results as brachytherapy, Goyal added.

Brachytherapy might be a more attractive option now than it was between 2003 and 2007, according to Goyal. "I presume that side effects will be lower because catheters and imaging modalities have improved."

However, Smith said he doubts that these improvements will bring mastectomy rates down following brachytherapy because all of the catheters aim to deliver radiation just to a 1-centimeter ring around the lumpectomy site.

While the current study looked at Medicare records of women who had already been treated, "the definitive trials [that follow women] comparing brachytherapy to whole-breast irradiation are still ongoing," but they are years away from giving definitive results, Smith said.

More information

To learn more about breast cancer treatments, visit the American Cancer Society.

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