PMU-Autor/inn/en
Sedlmayer FelixAbstract
Purpose: In women with favorable early breast cancer treated by lumpectomy plus tamoxifen or anastrazole, it remains unclear whether whole breast radiotherapy is beneficial. Methods and Material: Between January 1996 and June 2004, the Austrian Breast and Colorectal Cancer Study Group (ABCSG) randomly assigned 869 women to receive breast radiotherapy +/- boost (n = 414) or not (n = 417) after breast-conserving surgery (ABCSG Study 8A). Favorable early breast cancer was specified as tumor size < 3 cm, Grading 1 or 2, negative lymph nodes, positive estrogen and/or progesterone receptor status, and manageable by breast-conserving surgery. Breast radiotherapy was performed after lumpectomy with 2 tangential opposed breast fields with mean 50 Gy, plus boost in 71% of patients with mean 10 Gy, in a median of 6 weeks. The primary endpoint was local relapse-free survival; further endpoints were contralateral breast cancer, distant metastases, and disease-free and overall survival. The median follow-up was 53.8 months. Results: The mean age was 66 years. Overall, there were 21 local relapses, with 2 relapses in the radiotherapy group (5-y rate 0.4%) vs. 19 in the no-radiotherapy group (5.1%), respectively (p = 0.0001, hazard ratio 10.2). Overall relapses occurred in 30 patients, with 7 events in the radiotherapy group (5-y rate 2.1%) vs. 23 events in the no-radiotherapy group (6.1 %) (p = 0.602, hazard ratio 3.5). No significant differences were found for distant metastases and overall survival. Conclusion: Breast radiotherapy +/- boost in women with favorable early breast cancer after lumpectomy combined with tamoxifen/anastrazole leads to a significant reduction in local and overall relapse. (C) 2007 Elsevier Inc.
Useful keywords (using NLM MeSH Indexing)
Aged
Aged, 80 and over
Antineoplastic Agents, Hormonal/therapeutic use*
Breast Neoplasms/drug therapy
Breast Neoplasms/pathology
Breast Neoplasms/radiotherapy*
Breast Neoplasms/surgery*
Female
Humans
Mastectomy, Segmental*
Middle Aged
Neoplasm Recurrence, Local
Nitriles/therapeutic use*
Prospective Studies
Radiotherapy Dosage
Survival Rate
Tamoxifen/therapeutic use*
Triazoles/therapeutic use*
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