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Study identifies methods to support adoption of cutting-edge breast cancer therapy


Researchers at the Feinstein Institute for Medical Research and Northwell Health's Department of Radiation Medicine have identified methods to increase use of the cutting-edge cancer radiation therapy, hypofractionation, in breast cancer patients. These findings, recently published in Advances in Radiation Oncology, demonstrate that most patients with breast cancer can be treated with a type of radiation therapy that is as effective, but has lower toxicity levels, compared to current treatments.

Hypofractionated radiation therapy is a type of radiation therapy used in cancer patients where a higher dose of radiation is administered over a shorter timeframe. Up until recently, it was thought that hypofractionated radiation therapy was ineffective for breast cancer patients. However, randomized clinical trials proved that this therapy is comparable to other radiation therapies in effectiveness while being less toxic. Even with this data, the adoption of this therapy in the United States is significantly lower than countries and regions with similar levels of medical care like Canada and Europe. Researchers in this study, including Lucille Nichols Lee, MD, Feinstein Institute member and assistant professor of Radiation Medicine at Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, looked to see if implementing certain programs in the radiation medicine department at Northwell Health would help to increase adoption.

"Hypofractionated radiation therapy is underused in the treatment of breast cancer despite equal control, less acute toxicity and similar side effects," said Dr. Lee who is senior author of the study. "We found that through the development of consensus-based treatment directives and peer review of cases by faculty in Northwell's radiation medicine department that our adoption rate of this therapy increased to more than 73 percent of woman treated for breast cancer."

In this study, researchers implemented consensus-based evidence-driven guidelines to help medical professionals make treatment decisions for patients. A prospective peer-reviewed case review program was also established in the radiation department where the course of treatment for each patient was reviewed for a consensus opinion. When there was a disagreement, the treating physician was expected to defend his or her choice and influence the group to change their mind or go with the consensus opinion. This all helped to increase adoption of hypofractionated radiation therapy for patients whose cancer met the criterion for this course of therapy.

"Being treated in three weeks instead of six, as seen with hypofractionation, is something that many breast cancer patients are looking for as it means less disruption of their daily lives," said Chairman of the Department of Radiation Medicine at Northwell Health and Feinstein Institute Professor Louis Potters, MD, who is also an author of the study. "By developing this program to increase adoption we are both meeting the patient's needs of reduced treatment time and less toxicity while also educating the medical community that the treatment regimen is an effective alternative."

"It takes many years to develop a new treatment program and then we face the challenge of the medical community adopting it into their practices so that patients can obtain the treatment," said Kevin J. Tracey, MD, president and CEO, the Feinstein Institute for Medical Research. "Research like Dr. Lee's, which identifies ways to break down these hurdles, is important to ensure patients have access to a therapy that has the potential to improve their lives."

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About the Feinstein Institute
The Feinstein Institute for Medical Research is the research arm of Northwell Health, the largest healthcare provider in New York. Home to 50 research laboratories and to clinical research throughout dozens of hospitals and outpatient facilities, the Feinstein Institute includes 4,000 researchers and staff who are making breakthroughs in molecular medicine, genetics, oncology, brain research, mental health, autoimmunity, and bioelectronic medicine – a new field of science that has the potential to revolutionize medicine. For more information about how we empower imagination and pioneer discovery, visit

Heather E. Ball Mayer
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