More women could avoid radiotherapy during their cancer treatment Australian study suggests

There has also previously been a reluctance to use MRI in patients with lower risk breast cancer due to concerns that the sensitive technology could lead to false-positives and unnecessary mastectomies. It is also much more expensive than a mammogram.

But the researcher determined that the forgone radiation more than paid for the additional costs of the medical imaging.

“Every woman who was on the study saved the health system $2900,” Mann said. The patients who avoided radiotherapy reported a reduced fear of cancer recurrence and improved quality of life compared with those who received radiotherapy.

Vicki Zugno, 67, was diagnosed with breast cancer in 2014 after undergoing a routine mammogram. She had noticed a flatness to the side of her breast in the months before the screening.

The Moonee Ponds resident signed up to the study because she wanted to avoid the side effects of radiotherapy.

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“Radiation is quite intense,” she said. “It didn’t sound like much fun.”

The former nurse met the criteria for avoiding radiotherapy. She was able to return to work two weeks after a small cancerous tumour was surgically removed from her breast and she started taking hormone-blocking tablets.

“I don’t think I even took a Panadol,” Zugno said. “It was very straightforward.” She has remained cancer-free ever since and does not live with the fear of it returning.

Mann said MRI scans were very thorough and reassured women that all cancer had been detected. They are spared the side effects of radiotherapy which can include short-term pain and fatigue and some ongoing discomfort in the breast.

Mann said while radiotherapy was an excellent treatment for cancer when needed, it was linked to a small risk of developing additional cancers and heart damage.

“Identifying those who can safely avoid it is a high priority,” he said.

There was another unintended finding from the study: cancer did not recur around the body in any of the 443 patients within five years of treatment.

“It raises the possibility that the small number of distant recurrences in these patients with lower risk cancer is not due to the cancer that has been known about, but due to the [other cancers in breast] that we have found and therefore treated in the trial,” Mann said.

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A larger, follow-up trial will be conducted to confirm the findings.

Victorian Comprehensive Cancer Centre Alliance executive director Grant McArthur said there was an increasing focus on de-intensifying cancer treatment.

“Radiation treatment is quite a long course,” he said. “There is travel time, time off work and side effects … all those things get reduced when we can de-intensify treatment. It improves patients’ quality of life.”

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