This Week in JAMA: May 2, 2012

In JAMA this week, researchers at the University of Texas MD Anderson Cancer Center and the University of Chicago report on the effects of brachytherapy versus whole-breast irradiation and subsequent mastectomy on the survival of older women with invasive breast cancer. The team retrospectively studied 92,735 women aged 67 and older with invasive breast cancer, 6,952 of whom were treated with brachytherapy after lumpectomy and 85 of whom were treated with whole-breast irradiation. The team found that the women treated with brachytherapy had a higher five-year incidence of subsequent mastectomy than the women treated with whole-breast irradiation. Further, brachytherapy was associated with more frequent infectious and non-infectious post-operative complications than whole-breast irradiation. Five-year overall survival rates were similar, however — 87.66 percent in patients treated with brachytherapy versus 87.04 percent in the whole-breast irradiation group. "In a cohort of older women with breast cancer, treatment with brachytherapy compared with WBI was associated worse with long-term breast preservation and increased complications but no difference in survival," the authors write.