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PRIME II Study Finds Certain Breast Cancer Patients May Be Able To Skip Radiation Therapy

You may have heard the news — On February 16, 2023, The New England Journal of Medicine published a study with evidence that certain breast cancer patients may be able to omit radiation therapy after breast-conserving surgery.  Omission of radiotherapy in this patient population remains controversial, underrepresentation of older patients with breast cancer in clinical trials has potentially led to undertreatment and overtreatment.

Is it true? If so, what does this mean?

 It’s essential to explore the context and details behind a study to fully understand what it means. And that’s why we’re here: Let’s break down the specifics together.

Who are the ‘Certain Patients’ in the Study?

PRIME II, is a phase 3 randomized clinical trial that was conducted in 76 centers in the United Kingdom, Greece, Australia, and Serbia. The primary goal of the trial was to assess local breast cancer recurrence.  The trial enrolled women ages 65 and up who met all the following criteria:

  • Early-stage, low-risk “hormone receptor-positive, node-negative, T1 or T2 primary breast cancer.”
  • Tumors up to 3 cm in dimension.
  • Received breast-conserving surgery with “clear margins”.
  • Received adjuvant endocrine therapy treatment to reduce the risk of recurrence.

What Were the Results of the Study?

1,326 breast cancer patients participated in the study. The patients were randomized; half of the women to receive radiation therapy and the other half received none.

After 10 years of follow up, here’s what they found:

  • Local recurrence was more common for those who didn’t receive radiation therapy.
  • Distant recurrence was not higher among those who didn’t receive radiation therapy.
  • Overall, the number of breast cancer survivors was virtually identical between both The survival rates were 80.8% for the non-radiation group and 80.7% for the radiation group.

What Does This Mean for Breast Cancer Survivors & Patients?

“The applicability of these results to clinical practice will be influenced by the balance of the risks and benefits of radiation as compared with those of adjuvant endocrine therapy.” Further research will help us better understand these findings and how they may affect possible treatment options and outcomes.

As women in the fight against breast cancer, education is one of our greatest powers. Never stop learning, listening, and leading the way toward change, giving yourself care and grace along the way. Empower your journey by joining Kicked It In Heels: A digital community of breast cancer survivors committed to honesty, healing, and hope. Your voice matters!

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