Shorter Radiation Therapy vs the standard in Breast Cancer Treatments

In Canada and Britain, the statistics were far different. At least two-thirds of women in both groups received the shorter therapy.

In the United States, total medical expenses for the shorter therapy in women for whom it was endorsed were $28,747. For comparable women receiving the longer course of treatment, the cost was $31,641. For the second group of women — for whom the shorter therapy was neither endorsed nor discouraged — medical costs were $64,723, compared with $72,860 for conventional therapy. Health insurers pay for radiation in a piecemeal fashion, and the shorter course involves about 16 doses, compared with about 33 with the conventional therapy.

Dr. Harold J. Burstein, a medical oncologist at Dana-Farber Cancer Institute in Boston, said that when the initial results of a Canadian trial on the shorter therapy were published in 2002, “there was real ambivalence about changing practice based on one study.” Doctors wanted to see what would happen as the women were followed over a longer time, and they wanted to see the result confirmed.

The results of that study contradicted years of practice in the field, said Dr. Gary M. Freedman, a breast radiation oncologist at the University of Pennsylvania and an author of the new study. In the 1970s and 1980s, when equipment was much less sophisticated, radiation oncologists found that shorter and more intense therapy burned women’s skin and scarred their breasts, making them shrivel and shrink over the ensuing decade.