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Brachytherapy Doubles Mastectomy Risk and Complications

Women treated with brachytherapy are at twice the risk of losing their breasts and suffering complications than those who were treated with whole-breast radiation, a new study shows.

Dr. Benjamin D. Smith and colleagues in the department of radiation oncology at MD Anderson Cancer Center in Houston, evaluated the Medicare claims of 130,535 U.S. female beneficiaries aged 66 and older who were diagnosed with incident-invasive breast cancer from 2000 to 2007.

Patients were treated with conservative surgery, which was then followed by accelerated partial breast brachytherapy alone or whole-breast irradiation. The Brachytherapy process involves temporarily placing a small radioactive source in the breast after lumpectomy.

Analysis of the data showed the incidence of brachytherapy increased during this time, with less than 1 percent of patients treated with brachytherapy in 2000 and 13 percent treated with brachytherapy in 2007.

“We found that women treated with brachytherapy experience a twofold increased risk for subsequent mastectomy,” Smith said in a news release.

He said the results of the study show that women treated with brachytherapy were more likely to lose their breast after their initial breast-conserving therapy.

Four percent of patients treated with brachytherapy underwent a subsequent mastectomy compared to 2.2 percent of patients treated with whole-breast irradiation. Also the risk for postoperative infection and noninfectious complications increased nearly twofold for women treated with brachytherapy. They were also more likely to experience radiation-related side effects like rib fracture, fat necrosis and breast pain.

Smith said the results were shocking. “ I did not expect that we would find a difference in outcomes between brachytherapy and whole-breast irradiation using this claims-based approach,” he said. “Such an approach has never been used before to evaluate breast brachytherapy.”

Researchers say the results of this study show the importance of waiting for “mature data” from randomized clinical trials before large-scale adoption of breast Brach therapy.

For more on medical safety issues, see the library of articles by Daytona Beach medical malpractice attorney.

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