Breast Cancer Patients Report Better RT Experience

A new study shows that the radiation therapy (RT) experiences of breast cancer largely exceeded their expectations, and that the short- and long-term side effects are often better than anticipated.

Researchers at the David Geffen School of Medicine at UCLA (USA) sent out a survey questionnaire to all patients who received treatment for breast cancer between 2012 and 2016. Eligible patients had six or more months of follow-up, and were without tumor recurrence. A total of 327 patients responded, who represented various disease stages; 18% had stage 0 breast cancer; 38% stage I; 34% stage II; and 9% stage III. As to treatment, 82% underwent breast-conserving surgery, 13% had axillary dissection, 37% received chemotherapy, and 70% received endocrine therapy.

All patients received RT, delivered as either standard whole-breast RT with or without regional nodal coverage, hypo-fractionated whole-breast RT, post-mastectomy RT or partial breast RT; the patients completed the survey a median of 31 months after completing RT. Survey questions assessed fears and beliefs about breast cancer treatment and side effects, as well as how the actual experience compared to initial expectations. Specifically, patients were asked if the treatment experience, short-term side effects and long-term side effects were as expected, worse than expected or better than expected.

The results showed that 90% found the actual experience of breast radiation therapy to be “less scary” than anticipated. Overall short-term and long-term side effects of radiation were better than expected or as expected for 83% and 84% of respondents, respectively. Patients also reported that side effects were less severe than or as expected for short-term breast pain, skin changes, and fatigue, as well as for long-term appearance changes, breast pain, breast size changes, and breast textural changes.

More than two-thirds of the patients reported that they had little to no prior knowledge of RT at the time of their diagnosis, yet nearly half also shared that they had previously read or heard “frightening” stories of serious side effects. The most common initial fears related to RT were concerns about damage to internal organs, skin burning, and becoming radioactive, but few patients found confirmation for these negative stories during treatment. The study was presented at the 59th annual meeting of the American Society for Radiation Oncology (ASTRO), held during September 20177 in San Diego (CA, USA).

“We hope that these data, which reflect the voices of past breast cancer patients, can help to counsel future patients and their physicians on the actualities of the modern breast radiation therapy experience,” said lead author and study presenter Narek Shaverdian, MD. “Patients who have received this treatment provide the most credible account of its actual impact, and their accounts show that outdated, negative stereotypes of breast radiation are almost universally found to be untrue.”

“Our study shows that women who received modern breast radiation therapy overwhelmingly found the treatment experience far better than expected. The negative stories out there are frightening and pervasive, but they generally are not reflective of the actual experience,” said Susan McCloskey, MD, MSHS, director of the Breast Service at UCLA Radiation Oncology and senior author of the study.

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David Geffen School of Medicine