UNPROVEN TECHNOLOGY

The new findings add to a report from 2010 showing that from 2001 to 2006, the use of brachytherapy after breast surgery rose steadily from less than one percent of cases to 10 percent.

“There is often a great deal of excitement for new treatments, but just because something is new doesn’t mean it’s better,” said Gross. “Women should ask their providers to discuss with them, ‘What do we really know about the risk and benefits of different treatment options?’”

An editorial published with the report echoes Gross’s concerns, although it adds that the study was observational and so is less robust than an experiment comparing the two treatments head-to-head.

In the editorial, entitled “When Hope Hinders Science and Patient-Centered Care”, Dr. Jennifer Malin of the University of California, Los Angeles, notes that the regulatory requirements for new medical devices do not include proving that they improve patient outcomes - a requirement when companies apply for drug approvals.

“After a capital investment has been made to acquire the device (…) uptake of the new technology occurs even in the absence of evidence of improved or even comparable outcomes,” she writes.

About one in eight women will be diagnosed with breast cancer at some point in her life, according to the American Cancer Society, but only a minority die from the disease.

After breast-conserving surgery, up to 40 percent of women see the cancer return, but that number can be reduced to about 10 percent with external-beam radiation of the whole breast. Common side effects are swelling and redness.

According to Gross, the benefits of radiation outweigh the harms for younger women, but some older women may safely skip the treatment.

“The first question (to ask your doctor) is, ‘Do I need radiation at all?’” Gross said. “The second question is, ‘What are the risks and benefits of the different radiation treatments?’”

SOURCE: Journal of Clinical Oncology, online October 22, 2012