Doctors’ breakthrough to reach thousands of breast cancer patients

Decades-old discovery to be rolled out across NHS, sparing 25,000 patients unnecessary radiotherapy


Twenty-five thousand breast cancer patients a year in the UK will be spared weeks of unnecessary radiotherapy - thanks to a decades-old discovery by two of Britain’s most eminent Jewish doctors which can now be rolled out across the NHS.

Professors Michael Baum and Jeffrey Tobias, with their colleague Professor Jayant Vaidya, found that a single dose of radiation delivered at the same time as a lumpectomy was as effective for 80 per cent of patients as the 15 to 30 sessions routinely prescribed – a procedure that will save the NHS millions.

“It will benefit breast cancer patients all over the world,” says Prof Baum, Professor Emeritus of Surgery at University College London, who performed the procedure for the first time in Haifa around 12 years ago.

Six centres were licensed to carry out the treatment in the UK two years ago, with a larger rollout pending the results of a 20-year trial, which came to a successful conclusion this week.

“Israel has nine centres to our six, and it will take a year or so for the NHS to gear up with the equipment and expertise in all hospitals here which treat breast cancer patients,” he said of the treatment, known as TARGIT-IORT. It targets the tumour bed via a device placed inside the breast immediately after the cancer has been removed.

The doctors developed the concept in 1998, and the result of their trial on 2,292 patients in 10 countries was published this week in the British Medical Journal.

Of the half randomly assigned a single dose at the time of surgery, eight out of 10 needed no further radiotherapy. Earlier studies also showed fewer side effects compared with conventional radiotherapy, with less pain, better cosmetic outcome and a better quality of life.

“We estimate 25,000 out of the 40,000 cases a year in the UK would be suitable for IORT,” said Prof Baum, who admitted there had been opposition to  the treatment in the UK, although 45,000 patients in 38 countries have already received it.   

The body responsible for assessing cost-effectiveness, however, did not dispute its benefits:  “NICE had already approved it alongside further research in centres which already have the equipment,” he said of what he called “a one-stop shop with equal outcomes and less toxicity”.  There was also, he said, a benefit in eliminating multiple hospital visits, often involving long journeys from a patient’s home, during a pandemic.

In addition, says Prof Tobias, Professor of Clinical Oncology at UCL and UCLH: “TARGIT-IORT reduces the burden on overstretched radiotherapy departments.” 

Radiologists are among those who have opposed introduction in the past, but the lead author of this week’s publication, Jayant Vaidya, professor of Surgery and Oncology at UCL, said: “With publication of these very positive long-term results, it is now clear this treatment should be made much more freely available.”  

Martin Ledwick, head information nurse at Cancer Research UK, which co-funded the trial, supported the new initiative. “Reducing the nuber of treatments and hospital visits is a good thing for patients,” he said.

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