Hypofractionated Whole-Breast Irradiation for Early-Stage Breast Cancer

Dr. James Yu Yale School of Medicine Cancer Outcomes, Public Policy, and Effectiveness Research Center Yale School of Medicine Department of Therapeutic Radiology New Haven, Connecticut MedicalResearch.com Interview with:
Dr. James Yu
Yale School of Medicine
Cancer Outcomes, Public Policy, and Effectiveness Research Center
Yale School of Medicine
Department of Therapeutic Radiology
New Haven, Connecticut

Medical Research: What is the background for this study? What are the main findings?

Response: Hypo fractionated radiation has been shown to be safe and effective, and more convenient for women with early stage breast cancer after lumpectomy.  It also has been identified by ASTRO as a practice that physicians can adopt to reduce healthcare expenses for patients and for society.  We looked at the National Cancer Database, a database created by the American College of Surgeons for trends in the use of hypo fractionated radiation for breast cancer through 2011.  We found that the use of hypofractionated radiation had increased to 22.8% in 2011.  I found this remarkable as it predated the ASTRO choosing widely guidelines, and indicated to me that physicians were already thinking of ways of making treatment more convenient and affordable for patients and insurers.

Medical Research: What should clinicians and patients take away from your report?

Response: Obviously, more needs to be done – the number of patients eligible for hypofractionated breast radiation is likely higher than the number of patients receiving it.  I think clinicians and patients should take way from the report that change occurs slowly but steadily, and that we should all be discussing with our patients and with other ways of making radiation treatment more affordable and convenient.

Medical Research: What recommendations do you have for future research as a result of this study?

Response: I think future research will follow these databases longitudinally and investigate whether hypofractionated radiation has been adopted further in the years since the ASTRO guidelines and the 2013 Choosing Wisely campaign.

Citation:

Adoption of Hypofractionated Whole-Breast Irradiation for Early-Stage Breast Cancer: A National Cancer Data Base Analysis
Wang EH1, Mougalian SS2, Soulos PR3, Rutter CE4, Evans SB4, Haffty BG5, Gross CP6, Yu JB7.
Int J Radiat Oncol Biol Phys. 2014 Aug 19. pii: S0360-3016(14)03410-5. doi: 10.1016/j.ijrobp.2014.06.038. [Epub ahead of print]