Research trial examines use of radiotherapy after mastectomy | News

Royal Surrey patients taking part in a research trial have helped to show that women with early-stage breast cancer can avoid radiotherapy after mastectomy (breast removal). 

The SUPREMO international trial (Selective Use of Post-operative Radiotherapy After Mastectomy) launched in 2007 at Royal Surrey and followed a group of seven patients over 10 years.

Led by the University of Edinburgh, the trial was carried out in 17 countries and analysed 1,607 patients in total.

It found that patients with intermediate-risk breast cancer who had a mastectomy and received anti-cancer drugs had similar 10-year survival rates whether or not they received radiotherapy.

At Royal Surrey, the SUPREMO research trial was led by Dr Robert Laing, who has since retired. Dr Hasina Thandar took over from Dr Laing following his retirement two years ago. She said: “The background to this trial is that for many patients who are diagnosed with early stage breast cancer, the treatment plan includes mastectomy, anti-cancer drugs and chest wall radiotherapy. 

“The use of radiotherapy has been standard practice to destroy any remaining cancer cells and reduce the risk of the cancer returning.

“The reason for this approach, however, was based on research carried out in the 1980s, which meant there was uncertainty about its benefits. The SUPREMO trial was set up to examine if the radiotherapy prolonged life or not.

“The results we’ve seen are extremely valuable and will help us have more informed treatment discussions, as they show that radiotherapy may not be needed.

“It’s important to point out that this trial has only analysed patients with intermediate-risk breast cancer.”

All patients recruited to the trial underwent mastectomy, axillary surgery (where lymph nodes are removed from the armpit) and modern anti-cancer therapy. 

Patients were randomly allocated to receive chest wall radiotherapy (808 women) or no radiotherapy (799). 

After the follow up period, the trial results showed there was no difference in the overall survival of patients, whether they received radiotherapy or not. Results revealed that 81.4 per cent of those who received radiotherapy were still alive, compared with 81.9 per cent of those who did not.

Researchers also found that there was no impact on the cancer spreading from the breast around the body. 

The trial was funded by the Medical Research Council, and the National Institute for Health and Care Research.