Tag: breast cancer

Categories : CancerTags :

One‑week Radiotherapy Course Effective for Early‑stage Breast Cancer

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New UK research has found that a one-week course of post-surgery radiotherapy is just as safe and effective as the traditional three-week course for people with early-stage breast cancer. 

The FAST-Forward trial, led by Keele’s Professor Murray Brunt and sponsored by The Institute of Cancer Research, London, followed more than 4000 patients for a decade after their treatment.  

The 10-year results of this phase III randomised trial, funded by the National Institute for Health and Care Research (NIHR) and published in the Lancet Oncology, show that a shorter, five-day radiotherapy schedule provides the same level of cancer control as the traditional three-week treatment.  

These findings build on previous five-year results that have already driven a shift in clinical practice. Since 2020, it is estimated that tens of thousands of people in the UK have already benefited from the shorter course on the NHS. Researchers expect this approach will also reduce the burden on people undergoing treatment for breast cancer worldwide and expand access to life-saving radiotherapy.  

Breast cancer is one of the most common cancers globally, and radiotherapy plays a critical role in reducing the risk of recurrence after surgery. A shorter treatment course is not only more convenient for patients – it also reduces hospital visits and eases pressure on radiotherapy services, making treatment more accessible.  

The research team compared the traditional schedule of 15 treatments over three weeks with two shorter schedules that used five treatments over one week. The two shorter courses gave slightly different amounts of radiation to allow the research team to work out the best dose.   

After 10 years, cancer coming back in the treated breast was very low in all three groups: 3.6% for the standard three-week treatment, 2.9% with the one-week treatment with a slightly higher dose, 2.1% with the one-week treatment with a slightly lower dose.   

The lower dose one-week treatment had side effects that were very similar to the standard approach, with no increase in long-term breast or chest wall changes. Because of this, this dose and schedule are now the recommended option.  

Professor Murray Brunt, chief investigator of the FAST-Forward study and Professor of Clinical Oncology at Keele University, said: “These 10-year results provide definitive long-term evidence that one-week radiotherapy given at an appropriate dose to the breast is a safe, effective, and more practical option for people with breast cancer. 

“By reducing treatment from 15 sessions to just five, we can offer patients the same excellent cancer control with fewer hospital visits, less disruption to their daily life, and reduced pressure on healthcare services. This approach has already transformed practice in the UK and has the potential to improve access to life-saving treatment for people with cancer worldwide. 

“Hearing patients talk about how much it helps to only need one week of radiotherapy has been really encouraging for everyone involved.”  

Professor Judith Bliss, Professor of Clinical Trials at The Institute of Cancer Research, London, who co-led the trial, said: “The FAST-Forward trial is transforming cancer treatment by reducing standard breast radiotherapy from 3 weeks to just one week, without compromising effectiveness.  

“The streamlined schedule has made radiotherapy more accessible, particularly for people who find it difficult to attend hospital and those in lower-income countries.”  

“The FAST-Forward trial is part of a long-term programme of research into improving breast cancer radiotherapy at The Institute of Cancer Research (ICR).  

“These final 10-year results mark a significant milestone in breast cancer treatment and reinforce the growing shift toward more efficient radiotherapy approaches. The success of FAST-Forward has led to the ongoing NIHR-funded FAST-Forward Boost trial, which is investigating whether more extensive radiotherapy – including an additional ‘boost’ dose for some patients – can also safely be delivered in five days.  

Professor Anthony Gordon, Director for NIHR’s Health Technology Assessment (HTA) Programme, added: “The legacy of the FAST-Forward trial is clear to see, with thousands of women benefiting from shorter courses of radiotherapy and fewer hospital visits, helping the health and care sector to achieve more effective and efficient use of resources. The new 10-year results show the benefit of investing in high-quality, long-term research to improve the health and wealth of the nation.  

“NIHR’s research aims to tackle the most urgent health and social care challenges, targeting the areas of greatest need and where the most significant impact can be made. The findings from the FAST-Forward trial have already made a considerable difference to the treatment regimens that breast cancer patients undergo, making them more efficient, while at the same time, easing pressure on NHS services.”

Source: Keele University

Categories : CancerTags :

New Drug with Fewer Side Effects Reduces Breast Density

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Photo by National Cancer Institute on Unsplash

Low doses of the investigational medicinal product endoxifen reduce breast density to the same extent as the standard treatment tamoxifen, but without causing such troublesome side effects. These are the findings of a new study from Karolinska Institutet which appears in the Journal of the National Cancer Institute. The results may have implications for future preventive treatment of breast cancer.

Tamoxifen is a well-established drug that has been used for more than 40 years to reduce the risk of recurrence in patients with breast cancer. The drug is also approved for prevention of breast cancer in women at increased risk.

However, the side effects of tamoxifen are a major problem. Many women experience menopausal-like symptoms, such as hot flushes, which means that many do not complete the treatment.

Endoxifen is the most active metabolite formed when tamoxifen is broken down in the body. The new study investigated whether endoxifen in tablet form could provide the same biological impact and a more predictable effect than tamoxifen.

A total of 240 healthy, premenopausal women were randomised to receive a placebo or 1 or 2 mg of endoxifen daily for six months. The researchers then measured mammographic breast density. High mammographic density can contribute to an increased risk of breast cancer but a reduction during treatment can be a good measure of therapeutic outcome.

”Both 1 and 2 milligrams of endoxifen resulted in a clear reduction in breast density compared with the placebo,” says Mattias Hammarström, co-author and PhD candidate at the Department of Medical Epidemiology and Biostatistics at Karolinska Institutet.

The results show that 1mg of endoxifen reduced breast density by an average of 19% and 2mg by 26%. Data from a previous study show that 20mg of tamoxifen reduces density by approximately 18.5%. The effect of low-dose endoxifen thus corresponded to that seen with tamoxifen.

Participants who received 2mg of endoxifen reported a greater worsening of hot flushes and night sweats compared with the lower-dose group, whilst the 1 mg group had a safety profile similar to that of the placebo with respect to serious side effects and biomarkers.

”Our results suggest that a lower dose may be sufficient to affect breast density, whilst also appearing to be better tolerated,” says Mattias Hammarström.

The study is a so-called proof-of-concept trial, meaning it is designed to demonstrate that a treatment produces the expected biological effect before larger and longer trials are conducted. However, the study cannot show whether endoxifen reduces the risk of breast cancer or recurrence.

Source: Karolinska Institutet

Categories : Cancer Surgeries & ProceduresTags :

Method Spots Early Signs of Infection in Post-mastectomy Reconstruction

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Rapid detection, treatment of infections could avoid complications, additional surgeries after mastectomy

Many of those women opt to have their breasts surgically reconstructed, most commonly with implants, but a relatively high percentage develop infections after implant surgery, requiring intravenous antibiotics and often removal of the implant. This can lead to additional surgeries, delays in cancer care and increased costs, as well as added emotional distress for women already under strain from cancer diagnosis and treatment.

To address this problem, researchers at Washington University School of Medicine in St. Louis have developed a new tool to detect reconstruction-related infections early, before they cause symptoms. This method, reported in the Journal of Clinical Investigation, could allow for preemptive treatment that preserves implants, improves patient outcomes and reduces the psychological and financial burden on patients.

Led by Jeffrey P. Henderson, MD, PhD, a WashU Medicine professor, the study identified biomarkers of infection in fluid drained from reconstruction patients’ breasts days or even weeks before symptoms appeared. This represents a major opportunity for improvement over existing diagnostic methods, which rely heavily on clinical symptoms, such as redness and inflammation, that take time to appear and can overlap with normal reactions to surgery.

The findings are available online and will publish in print Feb. 16 in the Journal of Clinical Investigation.

“The ability to identify with a molecular signature early on that a patient will go on to have an infection opens up the possibility of surveillance as part of standard care,” Henderson said. “This has the potential to enable earlier treatment that would be far more effective – and potentially curative – in patients who would otherwise progress to prolonged courses of treatment and surgery, or even implant removal and reconstructive failure.”

Small molecules, big impact

The study originated when Henderson’s WashU Medicine colleague Margaret A. Olsen, PhD, a retired professor of medicine in the Division of Infectious Diseases who studies hospital infections, noticed high rates of infection among US patients who had reconstruction with implants after mastectomy. The discovery prompted Henderson and Olsen, a co-author on the study, to ask WashU Medicine plastic surgeons who performed breast reconstruction what they would need to improve outcomes in these patients. Their answer was simple: a clear yes/no test for infection.

To develop such a test, Henderson and lead author John A. Wildenthal, an MD/PhD student, leveraged their expertise in metabolomics, the study of metabolites that are created or broken down during cellular processes in the body. Metabolites can indicate the presence of an infection because they include byproducts of both the body’s response to pathogens and the metabolic activity of the pathogens themselves. By analysing changes in metabolite levels, scientists can identify patterns that are characteristic of infections, enabling early diagnosis.

Henderson and colleagues coordinated with WashU Medicine plastic surgeons to obtain fluid samples from 50 patient volunteers during several routine follow-up visits after surgery. The patients included women who later developed infections after post-mastectomy reconstruction and those who did not.

The researchers analysed the samples for differences between the two groups and identified metabolites that were significantly associated with infection and that appeared days to weeks before clinical signs and symptoms of infection. Further, they found that the presence of certain metabolites indicated more serious infections that might require more aggressive treatment.

“Originating from clinical intuition and validated through a clinical study, the evidence in this paper now supports proactive, targeted interventions to predict and address infections before they become clinically significant,” said Justin M. Sacks, MD, a co-author on the paper. “Such interventions can substantially reduce the burden of complications, implant loss and reconstructive failures in these patients.”

For instance, the findings could lead to the development of a point-of-care test that could be provided during a woman’s routine post-operative visits, noted co-author Terence M. Myckatyn, MD, a professor of surgery at WashU Medicine, who performs plastic and reconstructive surgery for breast cancer patients.

“If the test is positive, antibiotics can be started preemptively in these select patients to thwart infection,” Myckatyn said. “And perhaps just as important, we would not give antibiotics to those with a negative test, thereby adhering to a thoughtful approach for antibiotic stewardship.” Such careful use of antibiotics is important for preventing antibiotic resistance, he said.

In the near term, the team is planning additional studies to validate the results. Then a diagnostic tool could be developed and tested in clinical practice. In the future, the broader metabolomic findings about the development of tissue infection in humans could allow physicians to more selectively target a variety of post-surgical infections, for example, by revealing new drug targets.

“While better techniques are always being sought, the reality is that infections still occur despite a meticulous surgical approach,” said Myckatyn. “To be able to identify biomarkers that can portend an infection days before it develops is huge.”

Source: Washington University

Categories : Lab Tests and ImagingTags :

Study Shows Low-Field MRI Is Feasible for Breast Screening

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Mass General Brigham’s evaluation of low-field MRI performance lays potential groundwork for this technology to be a lower-cost, accessible option for breast imaging

Photo by National Cancer Institute on Unsplash

Researchers at Mass General Brigham have demonstrated the technical feasibility of using ultra-low field (ULF) magnetic resonance imaging (MRI) for breast imaging. With further refinement and evaluation, the technology could offer an alternative to existing breast cancer screening methods and may reduce barriers to screening. Results are published in Scientific Reports.

“These results are a very encouraging proof of principle, though larger studies are needed to establish diagnostic performance,” said project principal investigator and co-senior author Matthew Rosen, PhD, an associate professor of Radiology and director of the Low Field MRI laboratory in the Athinoula A. Martinos Center for Biomedical Imaging in the Mass General Brigham Department of Radiology. “They motivate our continued pursuit of safe, comfortable, lower-cost screening approaches that can expand access for patients.”

Current U.S. guidelines recommend screening mammography for women aged 40 to 74 years. Unlike mammography, ULF MRI doesn’t require breast compression, which many patients find uncomfortable. Another benefit of ULF MRI is that it doesn’t use ionizing radiation.

While higher risk patients may receive MRI screening for breast cancer, standard MRI machines are not used in routine breast cancer screening because they are expensive and not widely available. ULF MRI systems cost less than 5% of the price of standard MRI systems and have lower long-term operating costs.

In this study, ULF MRI scans were performed on 14 participants, including 11 women with no history of breast cancer, two women with a prior breast cancer diagnosis, and one woman with a benign mass.

When interpreting the ULF MRI scans, three radiologists could reliably identify essential breast features and distinguish fibroglandular tissue from adipose tissue. The authors note that discrepancies were likely related to the novelty of ULF MRI and may be reduced with additional training and experience.

“This early evidence suggests that ULF MRI can detect essential breast features and some abnormalities without radiation or injected contrast,” said co-first author Neha Koonjoo, PhD, an investigator at the Martinos Center. “These findings point to the potential for ULF MRI as an option that could complement existing screening tools in the future.”

“Even at very low magnetic field, the radiology team was able to make observations about the breast,” said co-principal investigator and co-senior author Kathryn E. Keenan, PhD, from the US National Institute of Standards and Technology. “We attempted this study in hopes that the breast features would be visible, but you don’t always have success. We’re very motivated by this study to continue our work on ultra-low-field MRI for breast screening.”

The researchers note that further study is needed to determine the diagnostic accuracy of ULF MRI for breast cancer screening, including studies in larger cohorts that include patients with benign and malignant lesions. They also emphasize that further refinements in ULF MRI technology are needed to meet clinical resolution standards for breast cancer screening.

“These results will guide the next engineering steps to improve image quality and enable a more comfortable exam and help bring screening to more settings and more patients,” said co-first author Sheng Shen, PhD, of the Martinos Center for Biomedical Imaging.

Source: Mass General Brigham

Categories : Cancer Obstetrics & GynaecologyTags :

Does a Past Abortion or Miscarriage Affect Breast Cancer Risk?

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Photo by National Cancer Institute

The potential effect of induced abortion and miscarriage on the risk of breast cancer has remained debated and has been a persistent source of misinformation. Many previous studies have been small and based on self-reported data. Now, a study published in Acta Obstetricia et Gynecologica Scandinavica found that prior abortion or miscarriage was not linked with an increased risk of developing pre- or postmenopausal breast cancer.

In the nationwide Finnish registry-based study, investigators analysed data on 31 687 women with breast cancer diagnosed in 1972–2021 and 158 433 women without breast cancer.

The risk of breast cancer was found to be similar among women with a history of induced abortion and women with no history of abortion, both before and after 50 years of age. Risks were also similar among women with and without a past miscarriage.

In addition, breast cancer risks did not vary significantly by the number of abortions or miscarriages, nor by the time of first abortion or miscarriage.

“Miscarriage or induced abortion as potential risk factors for breast cancer has continued to raise concerns and has led to the spread of misinformation. In this study using high-quality Finnish registry data, we can reliably eliminate these concerns,” said corresponding author Oskari Heikinheimo, MD, PhD, of the University of Helsinki and Helsinki University Hospital. “Induced abortion or miscarriage are not risk factors for breast cancer, even if there are several of them. This information is important and reassuring for millions of women around the world.”

Source: Wiley

Categories : Cancer Obstetrics & GynaecologyTags :

Hot Flush Treatment has Anti-breast Cancer Activity, Study Finds

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Photo by engin akyurt on Unsplash

A drug mimicking the hormone progesterone has anti-cancer activity when used together with conventional anti-oestrogen treatment for women with breast cancer, a new Cambridge-led trial has found.

In the two-week window that we looked at, adding a progestin made the anti-oestrogen treatment more effective at slowing tumour growth. What was particularly pleasing to see was that even the lower dose had the desired effectRebecca Burrell

A low dose of megestrol acetate (a synthetic version of progesterone) has already been proven as a treatment to help patients manage hot flushes associated with anti-oestrogen breast cancer therapies, and so could help them continue taking their treatment. The PIONEER trial has now shown that the addition of low dose megestrol to such treatment may also have a direct anti-cancer effect.

Around three-quarters of all breast cancers are ER-positive. This means the tumours are abundant in a molecule known as an oestrogen receptor, ‘feeding’ on the oestrogen circulating in the body. These women are usually offered anti-oestrogens, medication that reduces level of oestrogen and hence deprives the cancer of oestrogen and inhibits its growth. However, reducing oestrogen levels can bring on menopause-like symptoms, including hot flushes, joint and muscle pain, and potential bone loss.

In the PIONEER trial, post-menopausal women with ER-positive cancers were treated with an anti-oestrogen with or without the progesterone mimic, megestrol. After two weeks of treatment, those that received the combination saw a greater decrease in tumour growth rates compared to those treated with an anti-oestrogen only.

Although further work is required in larger patient cohorts and over a longer period of time to confirm the findings, researchers at the University of Cambridge say the trial suggests that megestrol could help improve the lives of thousands of women for whom anti-oestrogen medication causes uncomfortable side-effects and can lead to some women stopping taking the medication.

PIONEER was led by Dr Richard Baird from the Department of Oncology at the University of Cambridge and Honorary Consultant Medical Oncologist at Cambridge University Hospitals NHS Foundation Trust (CUH). He said: “On the whole, anti-oestrogens are very good treatments compared to some chemotherapies. They’re gentler and are well tolerated, so patients often take them for many years. But some patients experience side effects that affect their quality of life. If you’re taking something long term, even seemingly relatively minor side effects can have a big impact.”

Some ER-positive breast cancer patients also have high levels of another molecule, known as progesterone receptor (PR). This group of patients also respond better to the anti-oestrogen hormone therapy.

To explain why, Professor Jason Carroll and colleagues at the Cancer Research UK Cambridge Institute used cell cultures and mouse models to show that the hormone progesterone stops ER-positive cancer cells from dividing by indirectly blocking ER. This results in slower growth of the tumour. When mice treated with anti-oestrogen hormone therapy were also given progesterone, the tumours grew even more slowly.

Professor Carroll, who co-leads the Precision Breast Cancer Institute and is a Fellow of Clare College, Cambridge, said: “These were very promising lab-based results, but we needed to show that this was also the case in patients. There’s been concern that taking hormone replacement therapy – which primarily consists of oestrogen and synthetic versions of progesterone (called progestins) – might encourage tumour growth. Although we no longer think this is the case, there’s still been residual concern around the use of progesterone and progestins in breast cancer.”

To see whether targeting the progesterone receptor in combination with an anti-oestrogen could slow tumour growth in patients, Dr Baird and Professor Carroll designed the PIONEER trial, which tested adding megestrol, a progestin, to the standard anti-oestrogen treatment letrozole.

A total of 198 patients were recruited at ten UK hospitals, including Addenbrooke’s Hospital in Cambridge, and randomised into one of three groups: one group received only letrozole; one group received letrozole alongside 40mg of megestrol daily; and the third group received letrozole plus a much higher daily dose of megestrol, 160mg. In this ‘window of opportunity’ trial, treatment was given for two weeks prior to surgery to remove the tumour. The percentage of actively growing tumour cells was assessed at the start of the trial and then again before surgery.

In findings published today in Nature Cancer, the team showed that adding megestrol boosted the ability of letrozole to block tumour growth, with comparable effects at both the 40mg and 160mg doses.

Joint first author Dr Rebecca Burrell from the Cancer Research UK Cambridge Institute and CUH said: “In the two-week window that we looked at, adding a progestin made the anti-oestrogen treatment more effective at slowing tumour growth. What was particularly pleasing to see was that even the lower dose had the desired effect.

“Although the higher dose of progesterone is licenced as an anti-cancer treatment, over the long term it can have side effects including weight gain and high blood pressure. But just a quarter of the dose was as effective, and this would come with fewer side effects. We know from previous trials that a low dose of progesterone is effective at treating hot flushes for patients on anti-oestrogen therapy. This could reduce the likelihood of patients stopping their medication, and so help improve breast cancer outcomes. Megestrol – the drug we used – is off-patent, making it a cost-effective option.”

Because women in the trial were only given megestrol for a short period of time, follow-up studies will be needed to confirm whether the drug would have the same beneficial effects with reduced side-effects over a longer period of time.

The research was funded by Anticancer Fund, with additional support from Cancer Research UK, Addenbrooke’s Charitable Trust and the National Institute for Health and Care Research Cambridge Biomedical Research Centre.

Personalised and precise cancer treatments underpin the focus of care at the future Cambridge Cancer Research Hospital. The specialist facility planned for the Cambridge Biomedical Campus will bring together world-leading researchers from the University of Cambridge and its Cancer Research UK Cambridge Centre and clinical excellence from Addenbrooke’s Hospital under one roof in a brand-new NHS hospital.

Reference

Burrell, RA & Kumar, S, et al. Evaluating progesterone receptor agonist megestrol plus letrozole for women with early-stage estrogen-receptor-positive breast cancer: the window-of-opportunity, randomized, phase 2b, PIONEER trial. Nature Cancer; 5 Jan 2026: DOI: 10.1038/s43018-025-01087-X

Republished from University of Cambridge under a Creative Commons licence.

Read the original article.

Categories : Cancer Lab Tests and ImagingTags :

Diagnostic Breast MRI may be Unnecessary for Some Patients with Early-stage Breast Cancer

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Adding breast magnetic resonance imaging (MRI) to a diagnostic mammogram did not reduce five-year cancer recurrence rates for patients with stage I/II hormone receptor (HR)-negative breast cancer, according to researchers at The University of Texas MD Anderson Cancer Center. 

The Phase III Alliance A011104/ACRIN6694 trial found that five-year locoregional recurrence rates were 6.8% in patients who received an MRI as part of a diagnostic work-up and 4.3% in those who did not. These data were presented today at the San Antonio Breast Cancer Symposium (SABCS) by principal investigator Isabelle Bedrosian, MD, professor of Breast Surgical Oncology (Abstract GS2-07).

“We have long assumed that finding more breast cancer on an MRI and removing it with surgery would help lower the chance of a patient’s cancer coming back,” Bedrosian said. “When you look at our findings alongside earlier trials, the message is clear: adding MRI before surgery doesn’t improve results for patients – and may not have to be used as a standard part of the diagnostic process.”

No additional MRI benefit in this group

The trial enrolled 319 patients between 2014 and 2018 with newly diagnosed stage I or II HR-negative breast cancer. These patients were eligible for lumpectomy and did not have germline BRCA1/2 mutations, bilateral breast cancer or a history of prior breast cancer. All patients had undergone diagnostic mammography with or without ultrasound prior to trial enrolment.  Patients were randomly assigned to undergo additional imaging by breast MRI (161 patients) or to receive no further imaging (158 patients).

Not only did breast MRI not impact five-year recurrence rates, but there were also not significant differences between groups for five-year distant recurrence-free survival nor overall survival. 

A small subset of patients with tumour subtypes (HR- HER2+ and HR-HER2-) and those over the age of 50 at diagnosis also showed no benefit to MRI.

Pre-op MRI not finding anything important

Breast MRI is a common part of the diagnostic evaluation because it can reveal cancer that mammography might not detect. However, the evidence that it improves surgical outcomes for patients has been limited.

“We believe the reason MRI did not reduce recurrence rates may be twofold,” Bedrosian said. “It is possible that MRI didn’t uncover many lesions that mammography hadn’t already found, or perhaps identifying and surgically removing those additional lesions was not important to reducing risk of the cancer coming back. It’s possible that in the group that did not receive MRI, radiation and chemotherapy effectively treated the occult areas of disease”. 

Experts are now analysing how often breast MRI identified additional lesions in the trial population to better understand why breast MRI did not impact oncologic outcomes.

Study limitations 

Limitations included that most patients involved in the trial had breast cancer that hadn’t spread to their lymph nodes, which may partly explain why recurrence rates were low overall. Despite being open to women of all ages, the study enrolled mostly older women who may have been less likely to benefit from breast MRI. 

Categories : CancerTags :

Single-dose Radiation Before Surgery Can Eradicate Breast Cancer

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These two magnetic resonance imaging (MRI) scans were taken 10 months apart. On the left, the blue arrow points to the edge of a breast tumour, and the red arrow locates a biopsy clip, which appears as a black dot. The MRI on the right, which includes the biopsy clip, shows the tumour is gone after a single, targeted dose of radiation and antihormone therapy.

A single, targeted high dose of radiation delivered before other treatments could completely eradicate tumours in most women with early-stage, operable hormone-positive breast cancer, according to a study led by UT Southwestern Medical Center researchers. The findings, published in JAMA Network Open, could shift the paradigm for patients with the most common form of breast cancer, who typically undergo surgery before a regimen of radiation therapy.

“This is a major advance in the field,” said study leader Asal Rahimi, MD, Professor of Radiation Oncology. “This treatment protocol provides patients a significant time savings, spares a lot of their tissue from irradiation, and allows them to still undergo any type of oncoplastic surgery they may choose, all while very effectively treating their disease.”

Like patients with other forms of cancer, those with breast cancer are typically treated with a combination of surgery to remove tumours, medications such as hormone blockers, chemotherapy, and radiation, often in that order. In addition, many patients choose to have breast reconstructive surgeries before radiation treatment.

Having targeted radiation prior to surgery has several benefits, including a more than 100-fold smaller volume of tissue being irradiated compared with whole breast radiation; one day of radiation compared with up to 6.5 weeks of radiation, creating a huge time savings for patients; and more options for patients seeking reconstructive surgery, explained Dr Rahimi.

Early-stage, hormone-positive breast cancer accounts for 60–75% of all breast cancers. Seeking a more time-efficient way to treat these patients, Dr Rahimi and her colleagues tested a strategy in which 44 patients started treatment with a single dose of targeted radiation. While typical radiation therapy protocols call for 1.8–2.67Gy per day for 16 to 33 days, the researchers divided the study participants into three groups and gave each patient a single dose of 30, 34, or 38Gy. The volunteers then went on hormone-blocking drugs and waited a median of 9.8 months until they underwent surgery to remove any residual tumour tissue.

In 72% of study participants, the surgeons found no residual tumor left, indicating that patients had a “pathological complete response.” An additional 21% of patients had a “near complete response,” meaning that their cancer was more than 90% eliminated.

Further analysis showed that time to surgery was the best predictor of response. The longer patients waited to undergo surgery, the more likely their tumours were to disappear, regardless of the radiation dose or tumour size. These results were probably due to the time it takes cells to die or be removed by the immune system after radiation therapy, Dr Rahimi explained.

This new treatment protocol could hold significant advantages over the current gold standard, said Marilyn Leitch, MD, Professor of Surgery. For example, being able to wait to schedule surgery will allow patients to plan for the disruption it brings to their lives. The radiation course lasts a single day rather than weeks. Plus, in the future, this new approach may eliminate the need for surgery in some patients.

“Much of the current research in breast cancer is looking at ways to reduce the extent of surgery, radiation, and/or medical therapy that is required to completely treat early-stage breast cancer. It is very exciting to be part of innovative research that can improve the quality of life of our cancer patients and minimize the extent of treatment they require,” Dr Leitch said.

The research team is currently enrolling patients in a phase two clinical trial. “If the results mirror the ones from this study, an initial targeted dose of radiation could become a new treatment option for patients with small, early-stage, hormone-positive breast cancer,” Dr Leitch said.

Source: UT Southwestern Medical Center

Categories : CancerTags :

Radiotherapy After Mastectomy Can Be Avoided

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Photo by Jo McNamara

Radiotherapy can be safely omitted as a treatment for many breast cancer patients who have had a mastectomy and are taking anti-cancer drugs, as shown in a study published in the New England Journal of Medicine. An international trial found that patients with early-stage breast cancer who underwent a mastectomy had similar 10-year survival rates whether or not they received radiotherapy.

Experts say the findings should help guide treatment discussions, as many patients who currently qualify for radiotherapy after mastectomy under existing guidelines may not actually need it.

Outdated practice

For many patients with early-stage breast cancer treated by mastectomy and anti-cancer drugs, chest wall radiotherapy has long been standard to kill any remaining cancer cells and lower the risk of recurrence. 

The practice is based on trials from the 1980s, now considered outdated, leaving uncertainty about its benefit and leading to variation in use worldwide.

The SUPREMO trial (Selective Use of Postoperative Radiotherapy after Mastectomy), led by the University of Edinburgh, studied the impact of chest wall radiotherapy in patients at intermediate risk of breast cancer returning. 

International trial

The group included women from 17 countries with one to three affected lymph nodes, as well as those with none but who had other tumour features of aggressive behaviour that increase the chance of recurrence.

All 1607 patients in the study underwent mastectomy, axillary surgery – removing lymph nodes from the armpit – and modern anti-cancer therapy. They were randomly assigned to chest wall radiotherapy (808 women) or no radiotherapy (799).

Little benefit

There was no difference in overall survival of patients after ten years of follow up – 81.4% of those who received radiotherapy were still alive, compared with 81.9% of those who did not.

Radiotherapy also had no impact on disease-free survival – the length of time without any cancer returning – or on the cancer spreading from the breast around the body, the study found.

Radiotherapy had minimal impact on cancer recurring at the site of mastectomy. Nine patients who received the treatment saw their breast cancer return on the chest wall, compared with 20 who did not. Side effects from radiotherapy were mild with no excess deaths reported from cardiac causes.

Improved drugs

Experts attribute radiotherapy providing less benefit than previously thought to progressive improvements in treatment, particularly better drug treatments, which continue to reduce the chances of the cancer returning, and boost survival rates.

The research team caution that the study only looked at those with intermediate-risk breast cancer. Patients with a higher risk of their cancer returning could possibly benefit from chest wall radiotherapy, they add.

The SUPREMO trial provides no evidence to support the continued use of radiotherapy to the area of the chest wall in most patients with intermediate-risk breast cancer who have undergone a mastectomy if they are also treated with modern anti-cancer drug treatment.

 Professor Ian Kunkler Institute of Genetics and Cancer, University of Edinburgh

Although reported toxicity in the trial was mild, we know that almost all patients experience some side effects of radiotherapy, that can even develop even some years after treatment. Avoiding unnecessary irradiation will reduce both treatment burden and, for example, the detrimental effects on breast reconstruction for these mastectomy patients.

 Dr Nicola Russell Netherlands Cancer Institute and study coordinator on behalf of the EORTC

The international research team included scientists from the UK, Netherlands, Australia and China.

Source: University of Edinburgh

Categories : Cancer General InterestTags :

Hope Blooms in Durban – A Spring High Tea with Purpose

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Photo by Joanna Kosinska on Unsplash

October is Breast Cancer Awareness Month, and what better way to celebrate than with floral elegance, an exquisite high tea, motivational speakers, and a live auction – all in the spirit of hope and healing.

On Saturday morning, 25th October 2025, at 11 am, PinkDrive will host their Hope Blooms High Tea at the Radisson Blu Hotel, Durban Umhlanga, a time of spring celebration and impactful fundraising.  And you’re invited!

PinkDrive is a non-profit organisation (NPO) committed to prolonging lives through early detection of gender-related cancers. They operate mobile health units – those iconic pink trucks – that travel to rural and township areas to provide essential screenings to those who lack or have limited access to adequate healthcare.

Recent Rio Tinto outreach statistics highlight the urgent need for such interventions. In just one week in KwaZulu-Natal, 2251 health services were rendered, including 146 mammograms and 141 clinical breast examinations.

PinkDrive receives no government funding, relying entirely on donations, corporate partnerships, and community support to sustain its essential work. Among these partners is Lee-Chem Laboratories through their Mandy’s brand.

“This cause is deeply important to us – we’ve proudly supported PinkDrive for many years as a long-term corporate partner because of the difference they make in communities that need it most,” says Bhavna Sanker, Marketing Manager at Lee-Chem Laboratories. “It is a privilege to stand alongside them in their efforts to promote early detection and prolong lives. The Hope Blooms fundraiser perfectly reflects our shared commitment to raising awareness, providing crucial screening, and ultimately bringing hope where it’s needed most,” she explains. “We therefore want to encourage the public to also get involved by purchasing a ticket and enjoying an uplifting morning in support of PinkDrive’s vital work.

According to Janice Benecke from PinkDrive, corporate sponsors and partnerships, like that of Mandy’s, enable them to deliver this essential community service. “Mandy’s has been a proud supporter of PinkDrive for many years, generously providing branding, hampers, and product samples, along with an annual donation,” she says. “Through sponsored events like Hope Blooms, we hope to inspire further partnerships and support for our mission.”

Dr Marion Algar, Clinical Oncologist at Hopelands Cancer Centre specialising in breast cancer treatment, and Advocate Pria Hassan, founder of Women of Africa and champion of accessible healthcare through initiatives like iBreast, will share their insights as guest speakers. The elegant affair will be hosted by the lovely Delia Kroll, Mrs SA 2024 finalist, and attendees can also look forward to a welcome drink, networking opportunities, raffle prizes, gift bags, and an exciting live auction. Proceeds will go towards supporting PinkDrive’s free services, including clinical breast examinations, education, pap smears, and funding toward a new mammogram truck. Last year’s event raised R25 000; this year’s goal is to double that amount through your support.

“Hope Blooms reflects the courage, resilience, and renewal that come with a breast cancer journey,” notes Benecke. “Just like flowers that bloom after winter, it’s a reminder that through awareness, support, and love, hope always finds a way to grow.”

She concludes: “We want everyone to leave with this key message, and it’sa motto that I live by: ‘Only Believe, All Things Are Possible.’ Just look at me, I am a walking miracle.”

Tickets are R695 per person with a floral dress code. 10% of proceeds go directly to PinkDrive, and bookings can be made at info.durban.umhlanga@radissonblu.com. So why not consider purchasing a corporate table, inviting members from your sports or social club, or coming along with friends to enjoy a morning of elegance and purpose?

We look forward to welcoming you.