Comparing 2 radiation treatments for elderly women with low-risk breast cancer

This article compared the outcomes of older patients with low-risk breast cancer treated with accelerated partial breast irradiation (APBI) or ultra-APBI. The authors found that both treatment methods resulted in similar outcomes and side effects in these patients. 

Breast cancer is the most commonly diagnosed cancer and the leading cause of cancer death in women. Common treatments include surgery, chemotherapy, and radiotherapy. In women older than 70 years, treatment choice should find a balance between quality of life and treatment aggressiveness, while maintaining effectiveness towards killing cancer cells. 

One treatment option for older patients with low-risk breast cancer includes APBI. This involves the administration of 8-10 sessions of radiotherapy during 4-5 days to the region of the breast where the cancer was. Ultra APBI is another option for low-risk breast cancer. It consists of administering a single session of radiotherapy. This might decrease side effects. However, it is not known whether ultra-ABPI has the same effectiveness and safety compared to standard APBI in older patients with breast cancer.

The study included 157 patients aged 70 or older with breast cancer. All patients underwent breast-conserving surgery (the removal of the tumor only while preserving the breast) followed by irradiation. Standard APBI was administrated at a high dose to 109 patients. These patients received a total dose of 32 to 34 Gy in 8 to 10 sessions (twice daily) for 4 to 5 consecutive days. 48 patients received ultra-ABPI in a single session of 16 Gy. Patients were followed up for 97 months in the ABPI group and 72 months in the ultra-ABPI group. 

After 6 years, a similar number of patients in the ABPI group (1.3%) and ultra-ABPI group (0%) had a local recurrence. Also, a similar number of patients in the ABPI group (4.3%) had distant metastasis (cancer spread to distant organs) compared to the ultra-ABPI group (2.4%). 86.7% in the ABPI group and 82.2% in the ultra-ABPI group were alive after 6 years. 

After treatment, 45% of the ABPI group and 33.3% of the ultra-ABPI group experienced complications. The most common complication was fibrosis (tissue scarring). Both groups had excellent rates of cosmetic outcomes (breast shape, color after treatment).

This study showed that APBI and ultra-APBI are equally efficient for the treatment of low-risk breast cancer in older women. 

This study was based on medical records. Information might have been missing. Further, randomized studies are needed.