CORRESPONDENCE

RESPONSE: Re: Randomized Trial of Breast Irradiation Schedules After Lumpectomy for Women With Lymph Node-Negative Breast Cancer

Timothy Whelan, Mark Levine

Affiliations of authors: T. Whelan, M. Levine, Cancer Care Ontario, Hamilton Regional Cancer Centre, and McMaster University, Hamilton, Ontario, Canada.

Correspondence to: Timothy Whelan, B.M., B.Ch., Hamilton Regional Cancer Centre, 699 Concession St., Hamilton, Ontario, L8V 5C2 Canada (e-mail: tim.whelan{at}hrcc.on.ca).

We agree with Drs. Pearcey and Lees that our study was directed to women with early-stage breast cancer undergoing breast-conserving surgery (1). To fully understand the economic benefits of the adoption of the shorter schedule of breast irradiation, a formal cost-minimization analysis should be performed. It is important to note, though, that most radiation therapy resources are involved in the delivery of daily treatments rather than the costs for consultation or planning (2). Although Drs. Pearcey and Lees estimate that the shorter radiation therapy schedule would apply to 20% of all their breast cancer treatments, in a city the size of Edmonton this would amount to a substantial number of women with breast cancer. In locations where 60% of women newly diagnosed with breast cancer have lymph node-negative disease and the rate of breast-conserving surgery is 70%, the shorter fractionation schedule could be applicable for up to 40% of newly diagnosed women.

REFERENCES

1 Whelan T, MacKenzie R, Julian J, Levine M, Shelley W, Grimard L, et al. Randomized trial of breast irradiation schedules after lumpectomy for women with lymph node-negative breast cancer. J Natl Cancer Inst 2002;94:1143–50.[Abstract/Free Full Text]

2 Hayman JA, Lash KA, Tao ML, Halman MA. A comparison of two methods for estimating the technical costs of external beam radiation therapy. Int J Radiat Oncol Biol Phys 2000;47:461–7.[Medline]



             
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