New research published in the Journal of the National Cancer Institute this month shows that targeted radiation for breast cancer has been widely overused. The research uses new criteria established in 2009 by the American Society for Radiation Oncology (ASTRO) for the use of brachytherapy (targeted irradiation for breast cancer). It compares that new criteria with patient records from the past several years, showing that 2/3 of those receiving brachytherapy probably should not have.
Using records from 138,815 U.S. women who'd received brachytherapy from 2000 to 2007, the study shows that most of them do not fit into the currently recommended criteria for the therapy. This would likely account for some higher recurrence rates amongst the women.
The study compared women who received targeted radiation and those who received the more common whole breast irradiation (WBI). It found that 29.6% of the women receiving brachytherapy would have been classified as "cautionary" (not likely to benefit) and 36.2% would have been classified as "unsuitable" under current ASTRO criteria.
The study briefly discussed cancer return rates (versus recurrence in WBI), but admits that this data would be too preliminary given the specific scope of the study itself.
Targeted irradiation is more convenient for women, since it requires only about a week of therapy instead of a full month, but is designed for very specific situations that only about 7-10% of breast cancer patients fall into. Its use, the study found, varies greatly by geographic region, by rural versus urban (urban is more likely), and by racial demographic (whites are more likely to receive it), but not necessarily by means or income (Medicare covers it).
Findings from another study published this year show that women who receive brachytherapy at twice as likely to eventually have a mastectomy than those who receive WBI.
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