Shorter-Course Radiation for Breast Cancer Safe, Effective

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After the tumor is surgically removed, the doctor inserts a small balloon into the cavity, attaches a catheter to the balloon, and delivers a high radiation dose by way of tiny radioactive seeds.

Beitsch used the Mammosite Radiation Therapy System, approved by the FDA in 2002. The manufacturer, which funded the study, wanted to conduct a post-approval study, he said.

Beitsch reported on 400 women (of more than 1,400 total) now followed up for almost four years. He found that the rate of early complications, such as pockets of accumulated fluid, were similar to those of patients receiving standard therapy. Cosmetic results were similar, too.

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The researchers reported 28 breast tumor recurrences (about 2 percent). "The range of recurrences for whole breast radiation is nearly zero to 5 percent," Beitsch said, so these results are comparable.

The best candidates for the seed therapy, he said, are women age 45 years or older, with tumors of three centimeters or less and a diagnosis of ductal cancer or ductal cancer in situ (DCIS). About 40 percent of women diagnosed with breast cancer would probably be candidates, Beitsch estimated.

In a third study presented at the meeting, a form of external beam radiation therapy called proton therapy reduced the risk of cancer patients developing a secondary malignancy by twofold, compared to traditional radiation therapy using photons.

Proton therapy is a more targeted radiation that delivers less radiation to surrounding areas than does photon radiation. However, during the delivery of proton therapy, neutrons are produced and scattered, and some experts fear this scatter radiation may boost the chances of a secondary cancer.

Researchers compared 503 patients with a variety of cancers -- including brain tumors, sarcomas and prostate cancer -- who had proton therapy against 1,600 who had photon therapy. After a one year or more of follow-up, 6.4 percent of those who had proton therapy got a second cancer, compared to 12.8 percent of those who got traditional photon therapy. The median followup (half were longer, half shorter) was 7.7 years for the proton group and 6.1 years for the photon patients.

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