Partial breast irradiation (PBI) appears to produce the same overall survival results as whole-breast radiation (WBRT) in women with early-stage breast cancer; however, more research will be necessary before this investigational treatment replaces WBRT as the standard of care in this patient group. The results of this study were presented at the 2009 annual meeting of the American Society of Clinical Oncology (ASCO) in Orlando, Florida.
Early breast cancer, or cancer that has not spread from the breast or axillary (under the arm) lymph nodes, is often treated with breast-conserving surgery (referred to as lumpectomy), which involves the removal of the cancer and surrounding tissue but not the entire breast. Patients undergoing lumpectomy are encouraged to undergo radiation therapy following surgery to destroy any cancer cells that may remain near the site of origin. Several clinical trials have established that in early breast cancer, radiation therapy following lumpectomy improves outcomes compared with lumpectomy alone in most patients.
Partial breast irradiation is an investigational technique that treats only the breast tumor area after a lumpectomy, as opposed to WBRT, which treats the entire breast. Partial breast irradiation typically involves a shorter course of radiation (depending on the method used, it can take as little as one week), whereas WBRT is typically a six-week course of daily radiation.
Researchers recently performed a systematic review of three clinical trials with a combined total of 1,140 patients—575 who were randomly assigned to WBRT and 565 who were randomly assigned to PBI. The analysis showed no difference between overall survival or distant metastasis for either group; however, PBI was significantly associated with an increased risk of local and axillary disease recurrence compared with WBRT.
While the researchers concluded that there is no difference in overall survival for women treated with WBRT or PBI, they also acknowledge that far more research is needed to draw any conclusions from this analysis. In the meantime WBRT remains the standard of care for women with early-stage breast cancer.
 Valachis A, Mauri D, Polyzos NP, et al. Partial breast irradiation or whole breast radiotherapy for early breast cancer: A meta-analysis of randomized controlled trials. Presented at the 2009 annual meeting of the American Society of Clinical Oncology, May 29-June 2, 2009, Orlando, FL. Abstract CRA532.
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