2024-SABCS-Takeaways - 11

RADIATION ONCOLOGY SPOTLIGHT
Evidence shows RT may be
omitted or reduced in some cases
without harming clinical outcomes
L
ess can be more when it
comes to treating breast
cancer, be it medical, surgical,
or radiation therapy (RT). The 2023
SABCS® saw NSABP B-51 making
a strong argument against nodal
irradiation for individuals who
convert to node negative following
neoadjuvant therapy. The 2024
SABCS® brought further evidence
in favor of right-sizing RT with
findings that endocrine therapy
(ET) may replace RT for patients
with low-risk DCIS. Continue
reading for key RT takeaways and
access meeting presentations
and slides until March 31, 2025, for
more details.
This year's meeting included
presentations reflecting a pushpull
between RT and ET for
different patient populations.
Although ET may replace RT
for patients with low-risk DCIS,
ET was shown to have more
treatment-related adverse events,
resulting in more therapeutic
discontinuations than RT for
older women with luminal-like
early breast cancer after breastconserving
surgery.
RT has long been the standard
of care post-mastectomy. Ten-year
survival data presented this year
showed no significant difference
in overall survival, chest wall
recurrence, or regional recurrence,
with or without chest wall irradiation
with optimal systemic therapy.
It is also clear that words
matter when discussing RT, ET,
and other treatment approaches,
including the omission of certain
treatments. Patient advocate
Stacey Tinianov, MPH, BCPA,
noted that clinicians too often
present evidence for and against
particular approaches in terms
of relative risk, which can be
terrifying for someone who
may be unfamiliar with risk
terminology. The same is true
of relative risk of side effects
associated with treatment.
" As you have shared decisionmaking
conversations, let's talk
about absolute risk, " Ms. Tinianov
said. " Let's talk about what's really
at stake. "
A small phase I trial suggests
that PARP inhibition can sensitize
triple-negative breast cancer to
RT therapy. Combining the PARP
inhibitor rucaparib and adjuvant
RT may reduce local-regional
recurrence at the cost of poorer
cosmesis. However, another trial
found that applying mepitel film
before the initiation of RT can
reduce the incidence of radiation
dermatitis and improve cosmesis.
FROM LEFT: Jean L. Wright, MD; Ian Kunkler, MD;
and E. Shelley Hwang, MD, MPH
December 10-13, 2024 | San Antonio, Texas
11
https://events.hubilo.com/sabcs2024/login https://events.hubilo.com/sabcs2024/login
2024-SABCS-Takeaways

Table of Contents for the Digital Edition of 2024-SABCS-Takeaways
