Radiotherapy and survival in breast cancer

Nearly 11 000 patients with early-stage breast cancer treated with breast-conserving surgery have participated in prospective phase 3 trials assessing the benefits of postoperative radiation to the breast. In The Lancet, the Early Breast Cancer Trialists' Collaborative Group (EBCTCG) update their meta-analysis of long-term outcome in these patients. 1 Early Breast Cancer Trialists' Collaborative Group (EBCTCG)Effect of radiotherapy after breast-conserving surgery on 10-year recurrence and 15-year breast cancer death: meta-analysis of individual patient data for 10 801 women in 17 randomised trials. Lancet. 2011; (published online Oct 20.)https://doi.org/10.1016/S0140-6736(11)61629-2 Summary Full Text Full Text PDF Scopus (2664) Google Scholar They report that radiotherapy leads to significant clinical benefits, with an overall 16% absolute decrease (19% vs 35%) in the risk of breast cancer recurrence and a 4% absolute decrease (21% vs 25%, p<0·0001) in the risk of dying from breast cancer. These results confirm that radiation is effective in eradication of much of the microscopic locoregional disease that might still be present after surgery. They also show that if radiation is not used, this persistent locoregional disease can metastasise and increase the chance of dying from breast cancer. Effect of radiotherapy after breast-conserving surgery on 10-year recurrence and 15-year breast cancer death: meta-analysis of individual patient data for 10 801 women in 17 randomised trialsAfter breast-conserving surgery, radiotherapy to the conserved breast halves the rate at which the disease recurs and reduces the breast cancer death rate by about a sixth. These proportional benefits vary little between different groups of women. By contrast, the absolute benefits from radiotherapy vary substantially according to the characteristics of the patient and they can be predicted at the time when treatment decisions need to be made. Full-Text PDF Open Access