Pandemic speeds up shorter breast cancer radiation

Researchers at Harvey L. Neiman Health Policy Institute and University of Pennsylvania discovered that women with early-stage breast cancer received shorter courses of radiation therapy during the COVID-19 pandemic.

They analyzed Medicare data from 2018 to 2021 and found that use of ultra-hypofractionated whole-breast irradiation (UH-WBI), which involves five treatments, rose from 1.7% to 8.4% of patients after the pandemic began.

At the same time, the number of patients receiving conventional radiation schedules of 22 or more treatments decreased from 23.2% to 16.4%. This change happened because the pandemic created a need to limit patient exposure to healthcare settings. Doctors responded by adopting UH-WBI, a treatment already supported by research showing it to be as effective as longer courses. The study included over 4,000 Medicare patients who had lumpectomies and received postsurgical radiation.

The researchers noted that older adults and those with multiple health problems benefited most from the shift to fewer treatments. Patients diagnosed after the pandemic started completed radiation therapy about three days sooner and received nearly two fewer treatments on average. The change also saved money, lowering average radiotherapy spending by roughly $412 per patient.

While adoption of the shorter therapy was highest in the Northeastern United States, researchers found that Black patients did not experience the same increase in access as White patients.