Scientists have confirmed that many people with early-stage breast cancer may only need five days of radiotherapy after surgery instead of the traditional three-week treatment plan.
The findings come from a major clinical trial that followed patients for an entire decade and found that the shorter treatment was just as safe and effective as the longer approach.
The results were published in The Lancet Oncology.
Breast cancer affects millions of people around the world and remains one of the most commonly diagnosed cancers in women. After surgery to remove tumors, radiotherapy is often used to destroy remaining cancer cells and lower the risk of recurrence.
Radiotherapy works by using carefully controlled radiation to target cancer tissue. Although highly effective, treatment schedules can be physically and emotionally demanding because patients usually need to attend hospital repeatedly over several weeks.
For many years, the standard treatment after breast cancer surgery involved 15 separate radiotherapy sessions over a three-week period. Patients often traveled to hospitals every weekday during treatment.
Researchers wondered whether a shorter treatment schedule could achieve the same results while making life easier for patients and reducing pressure on healthcare systems.
To answer this question, scientists launched the FAST-Forward trial, a large phase III randomized study involving more than 4,000 patients.
The researchers compared the traditional three-week radiotherapy schedule with two alternative one-week schedules that delivered treatment over just five sessions.
The two shorter schedules used slightly different radiation doses to help researchers determine the safest and most effective amount.
The results after 10 years were highly positive. Cancer recurrence rates remained very low across all treatment groups.
Among patients receiving the traditional three-week treatment, 3.6% experienced cancer returning in the treated breast. In one of the one-week groups, recurrence was 2.9%, while in the lower-dose one-week group, recurrence was only 2.1%.
Researchers also carefully studied long-term side effects. The lower-dose one-week treatment produced side effects very similar to the standard three-week approach. Patients did not experience increased long-term damage to the breast or chest wall.
Because of these findings, the lower-dose five-day treatment schedule is now recommended for many patients.
Professor Brunt said the results provide strong evidence that shorter radiotherapy schedules can safely deliver excellent long-term cancer control.
He explained that reducing treatment from 15 visits to just five can significantly improve quality of life for patients. Many people undergoing cancer treatment face challenges such as fatigue, travel costs, work disruption, childcare responsibilities, and emotional stress. Shorter treatment plans can reduce some of these burdens.
The new approach has already changed breast cancer care in the United Kingdom. Since 2020, large numbers of patients treated through the National Health Service have benefited from the shorter schedule.
Researchers believe the impact may become even more important globally. In some countries, access to radiotherapy remains limited because hospitals lack enough machines, trained staff, or treatment centers. Long waiting lists can delay treatment for cancer patients.
By shortening treatment times, hospitals may be able to treat more patients using the same resources. This could expand access to life-saving radiotherapy in lower-income countries and regions with overburdened healthcare systems.
Co-lead researcher Judith Bliss said the streamlined treatment schedule has made radiotherapy more accessible for people who struggle to travel frequently to hospitals.
The FAST-Forward study is also part of a broader movement toward making cancer treatment more efficient and personalized. Researchers are continuing to investigate whether more advanced forms of breast radiotherapy can also safely be delivered within five days.
One ongoing study, known as the FAST-Forward Boost trial, is exploring whether patients who require extra radiation “boost” doses can still benefit from shorter treatment schedules.
Cancer specialists say the success of the FAST-Forward trial highlights the importance of carefully designed long-term clinical trials. The earlier five-year results had already encouraged doctors to adopt the shorter schedule, but the new 10-year data provide much stronger confirmation of long-term safety.
The findings also demonstrate how cancer treatment can evolve to become more patient-centered. In the past, longer treatments were often assumed to be safer or more effective. Modern research now allows scientists to test whether simpler approaches can provide equal benefits with fewer side effects and less burden on patients.
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Source: Keele University.
