A prospective analysis of two studies that used the 5-mm interval slices and 5-mm margin-free method for ipsilateral breast tumor recurrence after breast-conserving surgery without radiotherapy.

Autor: Ohsumi S; Department of Breast Oncology, National Hospital Organization Shikoku Cancer Center, 160 Kou, Minami-umemoto-machi, Matsuyama, Ehime, 791-0280, Japan. osumi.shozo.ur@mail.hosp.go.jp., Nishimura R; Department of Breast Oncology, Kumamoto Shinto General Hospital, Kumamoto, Kumamoto, Japan., Masuda N; Department of Breast and Endocrine Surgery, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan., Akashi-Tanaka S; Department of Breast Surgical Oncology, Show University School of Medicine, Tokyo, Japan., Suemasu K; ARCHE Clinic, Saitama, Saitama, Japan., Yamauchi H; Department of Breast Surgical Oncology, St. Luke's International Hospital, Tokyo, Japan., Tokunaga E; Department of Breast Oncology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Fukuoka, Japan., Ikeda T; Department of Surgery, Kitasato University Kitasato Institute Hospital, Tokyo, Japan., Nishi T; Toda Chuo Health Exam Center, Toda, Saitama, Japan., Hayashi H; Department of Surgery, National Hospital Organization Kanmon Medical Center, Shimonoseki, Yamaguchi, Japan., Iino Y; Department of Breast and Thyroid Surgery, Kusunoki Hospital, Fujioka, Gunma, Japan., Takatsuka Y; Department of Breast Surgery, Kansai Rosai Hospital, Amagasaki, Hyogo, Japan., Ohashi Y; Faculty of Science and Engineering, Chuo University, Tokyo, Japan., Inaji H; Department of Breast Surgery, Kaizuka City Hospital, Kaizuka, Osaka, Japan.
Jazyk: angličtina
Zdroj: Breast cancer (Tokyo, Japan) [Breast Cancer] 2023 Jan; Vol. 30 (1), pp. 131-138. Date of Electronic Publication: 2022 Sep 30.
DOI: 10.1007/s12282-022-01406-5
Abstrakt: Background: Breast-conserving surgery with radiotherapy is one of standard treatments for early breast cancer. However, it is regarded as an option to treat elderly patients with small hormone receptor-positive breast cancer with breast-conserving surgery and hormone therapy without radiotherapy. We conducted two sequential prospective studies to examine the feasibility of breast-conserving surgery without radiotherapy since 2002 and present the results.
Patients and Methods: Primary female breast cancer patients who fulfilled the strict eligibility criteria were prospectively enrolled in two sequential studies named WORTH 1 and 2. The surgical materials were sliced in 5-mm intervals and all slices were examined microscopically. Postoperative radiotherapy was not allowed, but tamoxifen or anastrozole was administered for 5 years. Ipsilateral breast tumor recurrence (IBTR)-free survival was the primary outcome.
Results: The data of the two studies were combined (N = 321). The median follow-up period for IBTR was 94 months (4-192 months). Only three patients were treated with adjuvant chemotherapy. The 5- and 10-year IBTR-free rates were 97.0% and 90.5%, respectively. The age at operation and PR status affected IBTR rates independently. When we calculated IBTR-free rates of patients who were 65 years of age or older at the time of surgery and had PR-positive tumors, the 5- and 10-year IBTR rates were both 98.4%.
Conclusions:  Our "5-mm-thick slice and 5-mm free-margin" method may be effective to select patients who can be treated by breast-conserving surgery and hormone therapy without radiotherapy.
(© 2022. The Author(s).)
Databáze: MEDLINE
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