The role of radiation therapy in the treatment of breast cancer

This review explored the benefits of radiation therapy in the management of breast cancer.

Radiation therapy plays an important role in the treatment of breast cancer. Radiation therapy has been shown to decrease the risk of cancer recurrence after surgery and improve survival rates among invasive cancer patients. Many advances have been made in the recent years in determining which patients would benefit most from radiation therapy, as well as in methods to decrease toxicities and damage to healthy surrounding tissue. This review investigated the current role of radiation therapy in breast cancer management.

Radiation therapy is currently thought to be beneficial for all patients with breast cancer, regardless of cancer stage. In a study examining irradiation following breast-conserving surgery (removal of an early stage tumor while preserving most of the breast), additional irradiation therapy reduced recurrence rates by up to 25%, while a separate analysis found the 10-year recurrence risk was reduced by 15%. Radiation therapy can also be successful when combined with other types of treatment. When compared to patients receiving only tamoxifen for example, patients receiving tamoxifen in addition to radiation therapy saw a 13.7% reduction in recurrence rates over 10 years.

Research has also been examining how to lessen the burden of radiation therapy on patients by reducing the number of sessions needed. Hypofractionation involves higher doses but less overall treatment time, and no need for daily treatments. Studies have found that toxicities are similar between hypofractionation and traditional radiation therapy. In addition, both long-term survival and cosmetic outcomes were also similar. Methods of partial breast irradiation, which deliver radiation to smaller areas of the breast, have also recently been shown to result in similar 5-year and 12-year recurrence rates as compared to whole breast radiation, allowing for a significant reduction in the rate toxic side effects.

Among more advanced cancer patients undergoing a complete mastectomy (removal of the entire breast), radiation therapy of the chest wall and the local lymph nodes has been shown to reduce local recurrence rates by up to 23%, although studies report wide variability among advanced cancer patients depending on the extent of lymph node involvement.

This review concluded that radiation therapy appears to be a crucial additive treatment for the prevention of cancer recurrence among women with breast cancer of any stage.