No breast cancer subgroup can be spared postoperative radiotherapy after breast-conserving surgery. Fifteen-year results from the Swedish Breast Cancer Group randomised trial, SweBCG 91 RT
Autor: | Lars Holmberg, Per-Uno Malmström, Per Karlsson, Fredrika Killander, Erik Holmberg, Jan Mattsson, Harald Anderson, Dan Lundstedt |
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Rok vydání: | 2016 |
Předmět: |
0301 basic medicine
Adult Cancer Research medicine.medical_specialty medicine.medical_treatment Postoperative radiotherapy Breast Neoplasms Mastectomy Segmental Disease-Free Survival Contralateral breast cancer 03 medical and health sciences 0302 clinical medicine Breast cancer Antineoplastic Combined Chemotherapy Protocols Breast-conserving surgery medicine Humans Longitudinal Studies skin and connective tissue diseases Cyclophosphamide Aged Neoplasm Staging Sweden business.industry Estrogen Antagonists Middle Aged medicine.disease Surgery Tumor Burden Radiation therapy Tamoxifen 030104 developmental biology Methotrexate Oncology Chemotherapy Adjuvant 030220 oncology & carcinogenesis Ipsilateral breast Lymph Node Excision Female Radiotherapy Adjuvant Fluorouracil Neoplasm Recurrence Local business Follow-Up Studies |
Zdroj: | European journal of cancer (Oxford, England : 1990). 67 |
ISSN: | 1879-0852 |
Popis: | Breast-conserving surgery (BCS) followed by radiotherapy (RT) is an established treatment for women with T1-2N0 breast cancers. Since subgroups of patients have low ipsilateral breast tumour recurrence (IBTR) rates, it is important to study whether RT is necessary for all patients.A total of 1187 women with primary T1-2N0M0 breast cancer were randomised, after standardised sector resection, to postoperative whole breast RT or no local treatment. Adjuvant systemic therapy was offered to patients with stage II cancers. Patients were followed with clinical examinations and annual mammography for 10 years and thereafter referred to the Swedish mammography screening program.After 15 years of follow-up, a higher cumulative incidence of IBTR was observed in control patients, 23.9%, versus irradiated patients, 11.5%, P0.001. Recurrence-free survival was inferior, 51.7% versus 60.4%, P=0.0013. The main effect of RT was seen during the first 5 years. However, overall survival was not significantly lower 68.4% versus 71.1%, P=0.68, nor was breast cancer-specific mortality significantly higher.RT after BCS significantly reduced the incidence of IBTR at 15 years of follow-up. We were unable to identify subgroups which could be spared RT. Breast cancer mortality was not significantly reduced after RT. Good predictive markers for radiation sensitivity and improved adjuvant systemic therapy are needed to omit RT after BCS. |
Databáze: | OpenAIRE |
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