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Title: Locoregional Recurrence of Breast Cancer in Patients Treated With Breast Conservation Surgery and Radiotherapy Following Neoadjuvant Chemotherapy

Abstract

Purpose: Breast conservation surgery (BCS) and radiotherapy (RT) following neoadjuvant chemotherapy (NCT) have been linked with high locoregional recurrence (LRR) rates and ipsilateral breast tumor recurrence (IBTR) rates. The purpose of this study was to analyze clinical outcomes in patients who exhibited LRR and IBTR after being treated by BCS and RT following NCT. Methods and Materials: In total, 251 breast cancer patients treated with BCS and RT following NCT between 2001 and 2006 were included. All patients had been shown to be clinically node-positive. Clinical stage at diagnosis (2003 AJCC) was II in 68% of patients and III in 32% of patients. Of those, 50%, 35%, and 15% of patients received anthracycline-based, taxane-based, and combined anthracycline-taxane NCT, respectively. All patients received RT. Results: During follow-up (median, 55 months), 26 (10%) patients had LRR, 19 of these patients had IBTR. Five-year actuarial rates of IBTR-free and LRR-free survival were 91% and 89%, respectively. In multivariate analyses, lack of hormone suppression therapy was found to increase both LRR and IBTR rates. Hazard ratios were 7.99 (p < 0.0001) and 4.22 (p = 0.004), respectively. Additionally, pathology stage N2 to N3 increased LRR rate (hazard ratio, 4.22; p = 0.004), and clinicalmore » AJCC stage III IBTR rate (hazard ratio, 9.05; p = 0.034). Achievement of pathological complete response and presence of multifocal tumors did not affect LRR or IBTR. Conclusions: In patients with locally advanced disease, who were clinically node-positive at presentation, BCS after NCT resulted in acceptably low rates of IBTR and LRR. Mastectomy should be considered as an option in patients who present with clinical stage III tumors or who are not treated with adjuvant hormone suppression therapy, because they exhibit high IBTR rates after NCT and BCS.« less

Authors:
 [1];  [1]; ; ; ; ; ;  [1];  [2];  [1];  [2]
  1. Center for Breast Cancer, Research Institute and Hospital, National Cancer Center, Goyang (Korea, Republic of)
  2. Proton Therapy Center, Research Institute and Hospital, National Cancer Center, Goyang (Korea, Republic of)
Publication Date:
OSTI Identifier:
22054465
Resource Type:
Journal Article
Journal Name:
International Journal of Radiation Oncology, Biology and Physics
Additional Journal Information:
Journal Volume: 81; Journal Issue: 5; Other Information: Copyright (c) 2011 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA); Journal ID: ISSN 0360-3016
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; CHEMOTHERAPY; DIAGNOSIS; HAZARDS; HORMONES; MAMMARY GLANDS; MULTIVARIATE ANALYSIS; NEOPLASMS; PATHOLOGY; PATIENTS; SURGERY

Citation Formats

Min, Sun Young, Department of Surgery, Kyung Hee University, Seoul, Lee, Seung Ju, Shin, Kyung Hwan, E-mail: radiat@ncc.re.kr, Proton Therapy Center, Research Institute and Hospital, National Cancer Center, Goyang, Park, In Hae, Jung, So-Youn, Lee, Keun Seok, Ro, Jungsil, Lee, Seeyoun, Kim, Seok Won, Kim, Tae Hyun, Kang, Han-Sung, and Cho, Kwan Ho. Locoregional Recurrence of Breast Cancer in Patients Treated With Breast Conservation Surgery and Radiotherapy Following Neoadjuvant Chemotherapy. United States: N. p., 2011. Web. doi:10.1016/J.IJROBP.2010.10.014.
Min, Sun Young, Department of Surgery, Kyung Hee University, Seoul, Lee, Seung Ju, Shin, Kyung Hwan, E-mail: radiat@ncc.re.kr, Proton Therapy Center, Research Institute and Hospital, National Cancer Center, Goyang, Park, In Hae, Jung, So-Youn, Lee, Keun Seok, Ro, Jungsil, Lee, Seeyoun, Kim, Seok Won, Kim, Tae Hyun, Kang, Han-Sung, & Cho, Kwan Ho. Locoregional Recurrence of Breast Cancer in Patients Treated With Breast Conservation Surgery and Radiotherapy Following Neoadjuvant Chemotherapy. United States. https://doi.org/10.1016/J.IJROBP.2010.10.014
Min, Sun Young, Department of Surgery, Kyung Hee University, Seoul, Lee, Seung Ju, Shin, Kyung Hwan, E-mail: radiat@ncc.re.kr, Proton Therapy Center, Research Institute and Hospital, National Cancer Center, Goyang, Park, In Hae, Jung, So-Youn, Lee, Keun Seok, Ro, Jungsil, Lee, Seeyoun, Kim, Seok Won, Kim, Tae Hyun, Kang, Han-Sung, and Cho, Kwan Ho. 2011. "Locoregional Recurrence of Breast Cancer in Patients Treated With Breast Conservation Surgery and Radiotherapy Following Neoadjuvant Chemotherapy". United States. https://doi.org/10.1016/J.IJROBP.2010.10.014.
@article{osti_22054465,
title = {Locoregional Recurrence of Breast Cancer in Patients Treated With Breast Conservation Surgery and Radiotherapy Following Neoadjuvant Chemotherapy},
author = {Min, Sun Young and Department of Surgery, Kyung Hee University, Seoul and Lee, Seung Ju and Shin, Kyung Hwan, E-mail: radiat@ncc.re.kr and Proton Therapy Center, Research Institute and Hospital, National Cancer Center, Goyang and Park, In Hae and Jung, So-Youn and Lee, Keun Seok and Ro, Jungsil and Lee, Seeyoun and Kim, Seok Won and Kim, Tae Hyun and Kang, Han-Sung and Cho, Kwan Ho},
abstractNote = {Purpose: Breast conservation surgery (BCS) and radiotherapy (RT) following neoadjuvant chemotherapy (NCT) have been linked with high locoregional recurrence (LRR) rates and ipsilateral breast tumor recurrence (IBTR) rates. The purpose of this study was to analyze clinical outcomes in patients who exhibited LRR and IBTR after being treated by BCS and RT following NCT. Methods and Materials: In total, 251 breast cancer patients treated with BCS and RT following NCT between 2001 and 2006 were included. All patients had been shown to be clinically node-positive. Clinical stage at diagnosis (2003 AJCC) was II in 68% of patients and III in 32% of patients. Of those, 50%, 35%, and 15% of patients received anthracycline-based, taxane-based, and combined anthracycline-taxane NCT, respectively. All patients received RT. Results: During follow-up (median, 55 months), 26 (10%) patients had LRR, 19 of these patients had IBTR. Five-year actuarial rates of IBTR-free and LRR-free survival were 91% and 89%, respectively. In multivariate analyses, lack of hormone suppression therapy was found to increase both LRR and IBTR rates. Hazard ratios were 7.99 (p < 0.0001) and 4.22 (p = 0.004), respectively. Additionally, pathology stage N2 to N3 increased LRR rate (hazard ratio, 4.22; p = 0.004), and clinical AJCC stage III IBTR rate (hazard ratio, 9.05; p = 0.034). Achievement of pathological complete response and presence of multifocal tumors did not affect LRR or IBTR. Conclusions: In patients with locally advanced disease, who were clinically node-positive at presentation, BCS after NCT resulted in acceptably low rates of IBTR and LRR. Mastectomy should be considered as an option in patients who present with clinical stage III tumors or who are not treated with adjuvant hormone suppression therapy, because they exhibit high IBTR rates after NCT and BCS.},
doi = {10.1016/J.IJROBP.2010.10.014},
url = {https://www.osti.gov/biblio/22054465}, journal = {International Journal of Radiation Oncology, Biology and Physics},
issn = {0360-3016},
number = 5,
volume = 81,
place = {United States},
year = {Thu Dec 01 00:00:00 EST 2011},
month = {Thu Dec 01 00:00:00 EST 2011}
}