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

Abstract

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 themore » 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.« less

Authors:
 [1];  [2];  [3];  [4];  [2];  [3];  [2];  [4]; ; ;  [5];  [6];  [7];  [8];  [9];  [2];  [4];  [3];  [10];  [2]
  1. Departments of Surgery and Radiotherapy, Medical University of Vienna, Vienna (Austria). E-mail: Richard.Poetter@meduniwien.ac.at
  2. Departments of Surgery and Radiotherapy, Medical University of Vienna, Vienna (Austria)
  3. Departments of Surgery and Radiotherapy, Wiener Neustadt Hospital, Wiener Nuestadt (Austria)
  4. Departments of Surgery, Radiotherapy and Internal Medicine, Hospital of the Sisters of Mercy, Linz (Austria)
  5. Departments of Gynaecology and Internal Medicine, Medical University of Graz, Graz (Austria)
  6. Department of Radiotherapy, St. Johanns-Hospital, Salzburg (Austria)
  7. Department of Surgery, Hanusch Hospital, Vienna (Austria)
  8. Department of Surgery, Regional Hospital, Weinviertel Mistelbach (Austria)
  9. Department of Surgery, Hospital Oberpullendorf, Oberpullendorf (Austria)
  10. ABCSG Statistics, Vienna (Austria)
Publication Date:
OSTI Identifier:
20951648
Resource Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 68; Journal Issue: 2; Other Information: DOI: 10.1016/j.ijrobp.2006.12.045; PII: S0360-3016(07)00064-8; Copyright (c) 2007 Elsevier Science B.V., Amsterdam, Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; CARCINOMAS; ESTROGENS; IRRADIATION; LYMPH NODES; MAMMARY GLANDS; METASTASES; PATIENTS; PROGESTERONE; RADIOTHERAPY; RECEPTORS; SURGERY; TAMOXIFEN; WOMEN

Citation Formats

Poetter, Richard, Gnant, Michael, Kwasny, Werner, Tausch, Christoph, Handl-Zeller, Leonore, Pakisch, Brigitte, Taucher, Susanne, Hammer, Josef, Luschin-Ebengreuth, Gero, Schmid, Marianne, Kapp, Karin, Sedlmayer, Felix, Stierer, Michael, Reiner, Georg, Hofbauer, Friedrich, Rottenfusser, Andrea, Poestlberger, Sabine, Haider, Karin, Draxler, Wolfgang, and Jakesz, Raimund. Lumpectomy Plus Tamoxifen or Anastrozole With or Without Whole Breast Irradiation in Women With Favorable Early Breast Cancer. United States: N. p., 2007. Web. doi:10.1016/j.ijrobp.2006.12.045.
Poetter, Richard, Gnant, Michael, Kwasny, Werner, Tausch, Christoph, Handl-Zeller, Leonore, Pakisch, Brigitte, Taucher, Susanne, Hammer, Josef, Luschin-Ebengreuth, Gero, Schmid, Marianne, Kapp, Karin, Sedlmayer, Felix, Stierer, Michael, Reiner, Georg, Hofbauer, Friedrich, Rottenfusser, Andrea, Poestlberger, Sabine, Haider, Karin, Draxler, Wolfgang, & Jakesz, Raimund. Lumpectomy Plus Tamoxifen or Anastrozole With or Without Whole Breast Irradiation in Women With Favorable Early Breast Cancer. United States. doi:10.1016/j.ijrobp.2006.12.045.
Poetter, Richard, Gnant, Michael, Kwasny, Werner, Tausch, Christoph, Handl-Zeller, Leonore, Pakisch, Brigitte, Taucher, Susanne, Hammer, Josef, Luschin-Ebengreuth, Gero, Schmid, Marianne, Kapp, Karin, Sedlmayer, Felix, Stierer, Michael, Reiner, Georg, Hofbauer, Friedrich, Rottenfusser, Andrea, Poestlberger, Sabine, Haider, Karin, Draxler, Wolfgang, and Jakesz, Raimund. Fri . "Lumpectomy Plus Tamoxifen or Anastrozole With or Without Whole Breast Irradiation in Women With Favorable Early Breast Cancer". United States. doi:10.1016/j.ijrobp.2006.12.045.
@article{osti_20951648,
title = {Lumpectomy Plus Tamoxifen or Anastrozole With or Without Whole Breast Irradiation in Women With Favorable Early Breast Cancer},
author = {Poetter, Richard and Gnant, Michael and Kwasny, Werner and Tausch, Christoph and Handl-Zeller, Leonore and Pakisch, Brigitte and Taucher, Susanne and Hammer, Josef and Luschin-Ebengreuth, Gero and Schmid, Marianne and Kapp, Karin and Sedlmayer, Felix and Stierer, Michael and Reiner, Georg and Hofbauer, Friedrich and Rottenfusser, Andrea and Poestlberger, Sabine and Haider, Karin and Draxler, Wolfgang and Jakesz, Raimund},
abstractNote = {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.},
doi = {10.1016/j.ijrobp.2006.12.045},
journal = {International Journal of Radiation Oncology, Biology and Physics},
number = 2,
volume = 68,
place = {United States},
year = {Fri Jun 01 00:00:00 EDT 2007},
month = {Fri Jun 01 00:00:00 EDT 2007}
}