The discovery means some people may be able to skip the accompanying side effects, too.
Thanks to earlier detection, better surgical techniques, and more targeted therapies, an increasing number of women are living healthy, disease-free lives following a breast cancer diagnosis. According to the Stanford Cancer Institute, more than half of women with the condition undergo radiation at some point in their treatment—a therapy that uses high-energy rays to kill remaining cancer cells after surgery. However, new research suggests that radiation might not be needed for those meeting certain criteria.
Published in The New England Journal of Medicine’s November 2025 issue, that study uncovered that radiation to the chest wall did not impact the 10-year survival rates in women with “intermediate risk” of recurrence who also underwent mastectomy and lymph-node surgery, and took advanced anti-cancer drugs.
To understand how the two courses of treatment compared, the team of researchers with concentrations in cancer and releated fields followed the health outcomes of roughly 1,600 patients—half of whom underwent chest wall radiation as part of their treatment, and half of whom who did not. The subjects were all diagnosed with Stage II breast cancer with one to three lymph nodes involved. Having spoken with the lead study authors, The New York Times reported that the majority of subjects did not undergo chemotherapy prior to their surgeries—a step which can further lower the need for radiation.
When the team assessed overall survival rates, they found that the two groups fared equally well, with the non-radiation group at a slight advantage. After a follow-up period of nearly 10 years, 81.4% of patients who had received radiation treatment had survived, as had 81.9% of those who had not undergone radiation.
The researchers also looked at other outcomes, including whether cancer came back in the chest wall, whether it came back regionally, and whether it spread to other parts of the body as metastatic cancer. The New York Times reports that in those patients who did ultimately see their cancer return, radiation did not impact the amount of time between treatment and a local recurrence in the breast—nor did it affect whether the disease spread to other parts of the body.
“We’ve now shown that with contemporary anti-cancer treatments, the risk of recurrence is very, very low—sufficiently low to avoid radiotherapy in most patients,” Dr. Ian Kunkler, chief investigator of the trial, told the New York Times. Dr. Kunkler, who is a consultant in clinical oncology at Scotland’s Edinburgh Cancer Centre, adds that this new insight contributes to a growing trend “toward de-escalation of radiotherapy in lower-risk groups of patients.” The side effects of radiation can include skin irritation, fatigue, pain, and lymphedema—swelling caused by problems in the lymphatic system.
For those facing tough decisions about their own cancer care, it’s important to understand that each case is different. Your doctor’s recommended course of treatment will be affected by type, stage, growth rate, hormone receptor status, and genetic risk factors, among other things.
For some people, radiation can still lower the risk of breast cancer returning or spreading, the researchers note. However, for select women who may have routinely received radiation in the past, the new findings suggest that opting out of the treatment could be just as safe.
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