Giving radiation therapy to the lymph nodes located behind the breast bone and above the collar bone to patients with early stage breast cancer improves overall survival without increasing side effects, and this effect continues for 15 years, researchers have found. Professor Philip Poortmans, head of the department of radiation oncology at the Institut Curie, Paris, France, will tell participants at the annual American Society for Clinical Oncology (ASCO) congress that these findings settle once and for all the question as to whether radiation therapy is beneficial for these patients.

Results from the international randomised trial, carried out by the European Organisation for the Research and Treatment of Cancer (EORTC) and which involved 4004 patients with stage I to III breast cancer from 43 centres, are convincing, he says. "Our results make it clear that irradiating these lymph nodes gives a better patient outcome than giving radiation therapy to the breast/thoracic wall alone. Not only have we shown that such treatment has a beneficial effect on disease control, but it also improves breast-cancer related survival," he will tell the meeting.

Lymphatic drainage from breast cancer to the regional lymph nodes means that the cancer is more likely to spread to other parts of the body. This drainage follows two pathways. The best known is to the axilla (armpit), and these lymph nodes are usually treated by surgery and/or radiation therapy. The second pathway drains to the internal mammary (IM) lymph nodes behind the breast bone, and probably from there to those just above the collar bone, the medial supraclavicular (MS) nodes. Because of uncertainty about the effects of treatment in this area, and particularly concerns about the increased toxicity that might be caused by the irradiation of a larger area, until recently only about half of radiation oncology centres treated the IM-MS lymph nodes.
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After a median follow-up of 15.7 years, the researchers found a significant reduction in deaths from breast cancer (16.0% in the treatment group vs. 19.8% in the control group), and in the return of breast cancer in patients who had received radiation to the IM-MS nodes (24.5% vs. 27.1%). A total of 1117 patients had died during the time. Overall survival was 73.2% in the IM-MS group and 70.8% in the control group. There was no increase in non-breast cancer related mortality in the first group and to date there has been no increased level of serious complications related to the treatment. There was no difference in the incidence of second cancers, cancer in the other breast, or deaths from cardiovascular disease between the two groups.

Wearable fitness trackers, such as the popular Fitbit, have the potential to help doctors predict which patients will do well on a course of chemotherapy, and be able to intervene before unexpected admissions to the hospital, experts believe.

Researchers said that in the future doctors might be able to use the technology in a number of ways, such as to predict which patients would not perform well in clinical trials. The study was presented at the American Society of Clinical Oncologists conference in Chicago.

“What we’ve learned is that we can get an objective metric of patient performance with the use of these modern technological tools,” stated Jorge Nieva, one of many authors of the analysis from the University of Southern California. He stated the expertise may in impact plug sufferers into the “internet of things”, referring to house items or gadgets which have a web-based connection.

“We’ve all got our home sprinkler systems and our thermostats, all connected to the internet – there’s no reason that our patients shouldn’t also be connected to the internet and have the potential to have monitoring and smart interventions, based on their performance and functioning,” Nieva stated.

Cancer researchers specifically have gravitated towards health trackers as a approach to objectively measure sufferers’ high quality of life. As of December 2015, almost 300 medical trials integrated health trackers to gather private knowledge, in keeping with Bloomberg.