A major international breast cancer study has found that patients with early-stage breast cancer can safely receive just one week of radiotherapy instead of the traditional three-week schedule.
Researchers say the shorter treatment works just as well at preventing cancer from returning and may greatly improve life for thousands of patients worldwide.
The study was led by researchers including Murray Brunt from Keele University and was published in the journal The Lancet Oncology. The research followed more than 4,000 breast cancer patients over a period of 10 years.
The findings come from the FAST-Forward trial, a large phase III randomized clinical trial designed to test whether fewer radiotherapy sessions could provide the same cancer control as the longer standard treatment.
Breast cancer is one of the most common cancers in the world. Millions of women are diagnosed every year, although men can also develop the disease. After surgery to remove breast cancer, many patients receive radiotherapy to destroy any remaining cancer cells and reduce the risk that the disease will return.
Traditionally, breast cancer radiotherapy has involved 15 treatment sessions spread over three weeks. Patients usually need to travel to the hospital every weekday during that period. For many people, especially older patients, people living far from treatment centers, or those balancing work and family responsibilities, this schedule can be exhausting and stressful.
Researchers hoped that a shorter course could make treatment easier without reducing safety or effectiveness.
In the FAST-Forward trial, scientists compared the standard three-week treatment schedule with two shorter schedules that delivered radiotherapy over just one week. Instead of 15 sessions, patients in the shorter-treatment groups received only five sessions.
The researchers adjusted the radiation dose slightly between the two one-week schedules to determine which amount worked best while minimizing side effects.
After following patients for 10 years, the results were highly encouraging. Cancer returning in the treated breast remained very rare in all groups.
Among patients who received the traditional three-week treatment, 3.6% experienced cancer recurrence in the treated breast. In the one-week group receiving the slightly higher radiation dose, the recurrence rate was 2.9%. In the one-week group receiving the slightly lower dose, the recurrence rate was only 2.1%.
The lower-dose one-week treatment also produced side effects very similar to the standard treatment approach. Importantly, researchers found no increase in long-term breast or chest wall damage.
Because of these results, the lower-dose one-week treatment schedule is now considered the preferred option.
Professor Brunt explained that the study provides strong long-term evidence showing that one week of radiotherapy can safely replace three weeks for many breast cancer patients.
He said the shorter treatment greatly reduces the number of hospital visits while still providing excellent cancer control. This can reduce disruption to patients’ daily lives and also ease pressure on busy healthcare systems.
The shorter schedule has already changed clinical practice in the United Kingdom. Since 2020, tens of thousands of patients treated through the National Health Service have benefited from the new approach.
Researchers believe the impact could become even larger worldwide, especially in countries where radiotherapy services are limited.
Radiotherapy machines and treatment centers are expensive and often overloaded in many parts of the world. Long waiting lists can delay cancer treatment for patients who urgently need care. By reducing treatment time from three weeks to one week, hospitals may be able to treat far more patients using the same equipment and staff.
Co-lead researcher Judith Bliss from The Institute of Cancer Research said the shorter schedule has made treatment more accessible, particularly for patients who struggle to attend hospital frequently or live in lower-income countries.
The FAST-Forward study is also part of a much larger effort to improve breast cancer radiotherapy. Researchers are now studying whether even more complex radiotherapy plans, including extra “boost” doses sometimes given to higher-risk patients, can also safely be completed within five days.
Experts say the study highlights how cancer care is gradually becoming more patient-friendly and efficient. Rather than automatically using older treatment schedules, scientists are carefully testing whether simpler approaches can provide the same or even better results.
The findings also show the importance of long-term clinical research. While earlier five-year results already influenced treatment guidelines, the new 10-year data provide much stronger reassurance about long-term safety and effectiveness.
Professor Anthony Gordon from the National Institute for Health and Care Research said the trial has already improved care for thousands of women while also helping healthcare systems use resources more efficiently.
Reviewing the findings, the study appears extremely important because it demonstrates that shorter radiotherapy schedules can maintain excellent cancer control without increasing long-term harm. The large number of patients and long follow-up period strengthen confidence in the results.
The reduced burden on patients and hospitals may also improve global access to radiotherapy, especially in regions with limited healthcare resources. However, researchers will continue studying whether similar shorter approaches work equally well for more complex breast cancer cases requiring additional radiation treatment.
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Source: Keele University.
