Shorter Radiation Courses May Improve Breast Reconstruction Outcomes

Shorter courses of radiation therapy may improve breast reconstruction outcomes without increasing complications, according to Dr. Reshma Jagsi, chair of the Department of Radiation Oncology at Emory University School of Medicine.

At the 42^nd Annual Miami Breast Cancer Conference, CURE spoke with Jagsi to discuss new research on optimizing radiation therapy for patients undergoing breast reconstruction. Traditionally, concerns have existed that shorter radiation courses could lead to more side effects or complications, according to Jagsi. However, recent studies indicate that these condensed treatment schedules maintain efficacy and may even enhance patient experience, particularly in younger individuals.

Findings from the recently published FABREC and RT CHARM trials support this approach, offering a more efficient treatment option.

Jagsi also highlighted findings from the Mastectomy Reconstruction Outcomes Consortium, which compared reconstruction techniques in the context of radiation therapy. The study found that tissue-based (autologous) reconstruction is less adversely affected by radiation than implant-based reconstruction, leading to better outcomes and higher patient satisfaction when feasible.

Beyond reconstruction, Jagsi addressed advancements in selecting patients who may safely omit radiation therapy after breast-conserving surgery. Research into breast cancer biology and genomic markers has helped identify subgroups with a low absolute risk of recurrence. While radiation significantly reduces recurrence risk, older patients with early-stage, estrogen receptor-positive tumors and favorable tumor biology may be candidates for omission.

Jagsi emphasized the importance of individualized treatment planning, balancing clinical data with patient values to optimize outcomes.

Transcript:

So one of the things that was really interesting that was presented just recently in the medical literature was looking at comparing shorter and longer courses of radiation treatment. And the concern when we shorten radiation courses is that we might actually increase the side effects of radiation, maybe have more complications from breast reconstruction. But what we actually found is that shortening the course of radiation therapy doesn't appear to make it worse, and might even in some patients, in one study, in younger patients, might even improve the experience with breast reconstruction.

So one thing is to potentially consider these shorter courses of radiation treatment, which also just have benefits to patients, because as much as patients love us as their physicians, I've never met one who wants to see me more often or for more treatments than she needs to have. So if we can give a more efficient approach to radiation, we very much would like to do that, and we now, thanks to two important trials just published in the last year, the FABREC trial and the RT CHARM trial, these landmark studies have given patients a really wonderful option to try to optimize their outcomes.

Transcript has been edited for clarity and conciseness.

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