Lumpectomy Plus Tamoxifen or Anastrozole With or Without Whole Breast Irradiation in Women With Favorable Early Breast Cancer

Journal Article · Fri Jun 01 04:00:00 EDT 2007 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2006.12.045· OSTI ID:20951648

Poetter, Richard ^[1]; Gnant, Michael ^[1]; Kwasny, Werner ^[2]; Tausch, Christoph ^[3]; Handl-Zeller, Leonore ^[1]; Pakisch, Brigitte ^[2]; Taucher, Susanne ^[1]; Hammer, Josef ^[3]; Luschin-Ebengreuth, Gero; Schmid, Marianne; Kapp, Karin ^[4]; Sedlmayer, Felix ^[5]; Stierer, Michael ^[6]; Reiner, Georg ^[7]; Hofbauer, Friedrich ^[8]; Rottenfusser, Andrea ^[1]; Poestlberger, Sabine ^[3]; Haider, Karin ^[2]; Draxler, Wolfgang ^[9]; Jakesz, Raimund ^[1]

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1. Departments of Surgery and Radiotherapy, Medical University of Vienna, Vienna (Austria)
2. Departments of Surgery and Radiotherapy, Wiener Neustadt Hospital, Wiener Nuestadt (Austria)
3. Departments of Surgery, Radiotherapy and Internal Medicine, Hospital of the Sisters of Mercy, Linz (Austria)
4. Departments of Gynaecology and Internal Medicine, Medical University of Graz, Graz (Austria)
5. Department of Radiotherapy, St. Johanns-Hospital, Salzburg (Austria)
6. Department of Surgery, Hanusch Hospital, Vienna (Austria)
7. Department of Surgery, Regional Hospital, Weinviertel Mistelbach (Austria)
8. Department of Surgery, Hospital Oberpullendorf, Oberpullendorf (Austria)
9. ABCSG Statistics, Vienna (Austria)

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 = 0.002, 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.

• OSTI ID: 20951648
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 2 Vol. 68; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
CARCINOMAS
ESTROGENS
IRRADIATION
LYMPH NODES
MAMMARY GLANDS
METASTASES
PATIENTS
PROGESTERONE
RADIOTHERAPY
RECEPTORS
SURGERY
TAMOXIFEN
WOMEN