Accelerated Radiation May Be as Good as Standard Schedule to Lower DCIS Recurrence Risk

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A small, early study suggests that a shorter, higher-dose radiation schedule after lumpectomy to remove DCIS (ductal carcinoma in situ) may reduce the risk of the cancer coming back (recurrence) just as much as a standard radiation treatment schedule.

The study was published in the June 2012 issue of the International Journal of Radiation Oncology*Biology*Physics. Read the abstract of "Five Year Outcome of 145 Patients With Ductal Carcinoma In Situ (DCIS) After Accelerated Breast Radiotherapy."

DCIS is the most common form of non-invasive breast cancer. DCIS is called "non-invasive" because it hasn’t spread beyond the milk duct into any normal surrounding breast tissue. DCIS isn’t life-threatening, but having DCIS can increase the risk of developing an invasive breast cancer later on. DCIS usually is treated with surgery to remove the cancer, lumpectomy in most cases. After surgery, many women have radiation therapy.

Radiation therapy after breast cancer surgery is most commonly given as 25 treatments -- you're treated 5 times per week for 5 weeks. A Gray is the way radiation oncologists measure the dose of radiation therapy; 50 Gray is the usual amount given during the 5 weeks (2 Gray at each treatment).

In accelerated radiation therapy, a higher dose of radiation is given at each treatment and there are fewer total treatments. The total amount of radiation given is about the same in each schedule.

Using an accelerated radiation schedule has been shown to be as effective as the standard schedule in reducing the recurrence risk of early-stage INVASIVE breast cancer. But using accelerated radiation after DCIS surgery hadn’t been studied until now.

This study involved 145 women who had been diagnosed with DCIS between 2002 and 2009 and had lumpectomy. The women then got one of two accelerated radiation schedules:

  • 59 women got 15 treatments of 2.8 Gray per treatment (a total of 42 Gray over 3 weeks)
  • 86 women got 15 treatments of 2.7 Gray per treatment (a total of 40.5 Gray over 3 weeks) with an additional daily boost of 0.5 Gray.

Five years after treatment, 4.1% of the women had a recurrence, which is the same recurrence rate found in other studies looking at the standard radiation schedule after DCIS surgery.

The results suggest that an accelerated radiation therapy schedule may be a good alternative to the standard schedule after DCIS surgery. The main advantage of the accelerated radiation therapy schedule is fewer treatments, which means you don't have to go to the doctor's office as much. Scheduling daily trips to the radiation oncologist's office to get radiation therapy treatment can be a problem for some women.

Still, more research is needed until doctors know for sure that an accelerated radiation therapy schedule works just as well as a regular schedule to reduce the risk of recurrence after DCIS surgery.

If you’ve been diagnosed with DCIS and radiation therapy is part of your treatment plan, your doctor will likely recommend a standard radiation schedule. If scheduling radiation treatments is a problem for you, talk with staff members at your radiation treatment center about your scheduling needs. They will try to work out an appointment schedule that's as convenient as possible for you.

You can learn more about DCIS in the Breastcancer.org DCIS pages and more about radiation therapy, including how it works and side effects, in the Radiation Therapy pages.

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