Fox Chase Cancer Center trial tests reducing radiation for breast cancer

PHILADELPHIA (WPVI) -- Cancer treatments are always evolving, with new medications and regimens. A trial currently underway here could clear the way for a big change in treating early-stage breast cancer.

For decades, a standard for stage 1 breast cancer has been a lumpectomy followed by radiation, then 5 years of hormone therapy.

Dr. Rebecca Shulman, a radiation oncologist at Fox Chase Cancer Center, says the DEBRA trial could add an option.

"Whether women with low-risk, hormone sensitive, early-stage breast cancer can safely skip radiation therapy after surgery," Dr. Shulman explains.

DEBRA stands for De-Escalating Breast Radiation After lumpectomy. Dr. Shulman says cutting out radiation could have benefits.

"We're trying to potentially reduce the risks of side effects," she says.

Those side effects include skin irritation and thickening, breast shrinkage or swelling, shoulder stiffness, or lymphedema. There's also the burden of travel to daily radiation sessions.

Genomic testing of the tumor's DNA now gives a better picture of whether the cancer is likely to return, so radiation may not be needed as insurance.

"Prior smaller studies show very low risks of recurrence with endocrine therapy alone," says Dr. Shulman.

The trial is open to those between 50 and 70 years of age, with Stage 1, hormone-receptor positive, HER-2 negative tumors less than 2 centimeters in size. They also need a score of 18 or less on an OncoType DX test, or Low on a MammaPrint test.

Patients would be randomized to get either radiation and endocrine therapy, or endocrine therapy alone.

"You would be getting routine clinical exams, mammograms, you would see an oncologist at least once a year, and you would be monitored for side effects," says Dr. Shulman. "It's the same care all patients receive here at Fox Chase."

And the DEBRA trial isn't just for women.

"Men are eligible as well," Dr. Shulman says.

Patients will be followed for 10 years, so the study will have plenty of data to compare the radiation and hormones versus the medication alone.

For information on the trial, CLICK HERE.