Long-Term Breast Radiotherapy Trials at Odds Over Risk of Second Malignancies

[Hopeful]

Rich,

When I was first dx, I did not want to do rads, and researched the effectiveness if tx. The report I read, which was a meta analysis of numerous reports on rads (if I can locate the link to it I will amend this post) showed that rads had a 5% absolute impact on overall survival at either 15 or 20 years out. The bottom line was, it took a long time for the survival improvements to become apparent.

The real question is, what is being affected by the rads to cause the improvement? Is it local control, preventing stray cells in the breast from creating mets, or is it systemic? Because radiation affects the bones, and we are now seeing that the bones can provide a favorable environment for cancer cells even when there are no apparent mets, it is possible that the effect of rads goes beyond the immediate area radiated and has a systemic effect. I discussed this with my rads onc a year or so ago. She said it was all part of the debate over partial breast irradiation or the standard field therapy, and it will take a long time to see if there is any difference, since it does not show up (statistically) right away.

Hopeful