National Institute for Health and Clinical Excellence (NICE)
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Study highlights benefits of radiotherapy after breast cancer surgery

Radiotherapy following breast-conserving surgery in breast cancer patients almost halves the risk of the cancer recurring, according to latest research published in the Lancet.

The study says radiotherapy following breast-conserving surgery "not only substantially reduces the risk of recurrence but also moderately reduces the risk of death from breast cancer".

These findings tie in with recommendations for care in NICE's guideline on the diagnosis and treatment of early and locally advanced breast cancer.

Published in 2009, the guideline states that breast radiotherapy should be offered to patients with early invasive breast cancer who have had breast conserving surgery with clear margins.

The Lancet study found that there is a clear reduction in cancer recurrence within the first year among breast cancer patients who have received radiotherapy, and that this lasts throughout the first decade after treatment.

Researchers brought together the data of 10,801 breast cancer patients in 17 randomised trials of radiotherapy after breast conserving surgery that were carried out worldwide.

Each woman was followed for an average time of ten years to determine the effect radiotherapy has after surgery on recurrence of disease and death.

Figures show that ten years after diagnosis of breast cancer, 35 per cent of women who did not have radiotherapy had a recurrence. This compares with 19 per cent of women who did have radiotherapy treatment.

Radiotherapy was also seen to have an impact on mortality from breast cancer. The study shows 15 years after diagnosis of breast cancer, less women died from the condition who had radiotherapy (21 per cent) than those who did not receive radiotherapy (25 per cent).

Furthermore, the study found no substantial effect of radiotherapy on 15-year risk of death from all causes apart from breast cancer. This meant that the 15-year risk of death from any cause was reduced by almost as much as the decrease in death from breast cancer.

The study authors said: "The overall findings from these trials show that radiotherapy after breast-conserving surgery not only substantially reduces the risk of recurrence but also moderately reduces the risk of death from breast cancer.

"These results suggest that killing microscopic tumour foci in the conserved breast with radiotherapy reduces the potential for both local recurrence and distant metastasis."

All of our guidance on breast cancer can be found in the online Pathways tool which provides a quick and easy way to access all the advice and recommendations provided by NICE.

 

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