It's safe to skip radiation in older women with early, low-risk, ER–positive breast tumors, say researchers reporting 10-year outcomes from the large phase 3 trial known as PRIME II.
in older women with low-risk tumors treated with lumpectomy and endocrine therapy, but the move has been controversial owing to a lack of long-term data, and use of radiation for such women remains common in the United States, the investigators explain.
Following lumpectomies with clear margins, the women underwent endocrine therapy; the investigators recommended tamoxifen at 20 mg/d for 5 years. At 10 years, 1.6% of women in the no-radiation arm had distant metastases as their first recurrence, vs 3% of women who underwent radiation. In addition, the recurrence rate was lower after radiation. The investigators suggest that lower adherence to endocrine therapy and lower levels of ER positivity increased the risk of local recurrence among women who didn't receive radiation.
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