Research: Accelerated breast radiation treatment provides same outcomes after 10 years
At her 50th wedding anniversary trip to Florida,
Anita Evans (center) enjoys time with her family.
Anita Evans was planning her 50th wedding anniversary celebration. She arranged for her husband, their children and grandchildren to spend an entire month in Florida. But in February 2000, during a routine physical examination, her doctor found a lump on her left breast.
“I didn’t have time for this. I’d been planning the trip for a while and arrangements had been made. I wanted to celebrate my wedding anniversary,” says Evans.
Evans was diagnosed with breast cancer, and soon after had the tumor, which was the size of a cherry pit, surgically removed. Shortly after the lumpectomy, she was referred to a radiation oncologist at Beaumont Hospital, Royal Oak who was leading a clinical trial of time-compressed radiation therapy after lumpectomy.
“At that time, Anita Evans was a perfect candidate for the five-day delivery of accelerated partial breast irradiation by brachytherapy, as opposed to whole breast irradiation delivered by the traditional six and a half weeks of external beam radiation therapy,” says Peter Chen, M.D., radiation oncologist, Beaumont, Royal Oak. “She fit the basic selection profile of an older patient greater than 50 years of age with a small tumor with no spread of cancer to the lymph nodes or elsewhere. We also wanted to try to do our best to get her back to normal health so she could enjoy her anniversary trip.”
Evans agreed to enroll in the clinical trial of radiation treatment called accelerated partial breast irradiation, or APBI, to kill breast cancer cells that may have remained after lumpectomy surgery. APBI via brachytherapy is an outpatient treatment, where Evans had 17 hollow tubes, or catheters, placed into her breast where the tumor was located and removed. A radioactive seed of high activity or intensity was then used to treat the breast twice daily, for five days.
Evans says the treatment was painless. She explains, “I felt no pain. It looked like they just inserted long knitting needles on one side of the breast that came out the other.”
And, there were no side effects.
“I returned twice every day for one week and felt fine. Two days later I was driving down to Florida,” says Evans, an 87-year-old grandmother from Beverly Hills.
Today, the treatment Evans received has been perfected. The Beaumont breast cancer team now places a single-entry catheter containing a soft balloon that once inside the breast delivers radiation treatment.
While Evans, an avid gardener, golfer and grandmother, has had no recurrence and has stayed cancer-free for more than a decade, she continues to get regular mammograms and follow-up care with Dr. Chen.
“Dr. Chen and I go back 13 years. He’s always been very conscientious, pleasant and is very knowledgeable. I’m glad I was able to participate in his trial,” says Evans who has since participated in two additional, unrelated studies. “I strongly believe in them. I feel it’s a contribution that I can make. In order to advance medicine, we have to participate in the research. It is certainly worthwhile.”
Beaumont radiation oncology resident Jessica Wobb, M.D. presented Dr. Chen’s updated research results at this year’s American Society for Radiation Oncology conference. The results showed that APBI, and traditional whole-breast irradiation are comparable at 10 years. While radiation therapy has traditionally been delivered using whole breast irradiation, APBI is a proven alternative that shortens the length of treatment and may improve quality of life. The study concludes that at 10 years, there have been no differences in cancer recurring or spreading.