Tangential Radiotherapy Without Axillary Surgery in Early-Stage Breast Cancer: Results of a Prospective Trial

Journal Article · Sat Nov 01 04:00:00 EDT 2008 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2008.01.031· OSTI ID:21128221

Taghian, Alphonse G ^[1]; Bellon, Jennifer R ^[2]; Keshaviah, Aparna ^[3]; Smith, Barbara L ^[4]; Winer, Eric P ^[5]; Silver, Barbara; Harris, Jay R ^[2]

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1. Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA (United States)
2. Department of Radiation Oncology, Dana-Farber/Brigham and Women's Cancer Center, Boston, MA (United States)
3. Department of Biostatistics and Computational Biology, Dana-Farber/Brigham and Women's Cancer Center, Boston, MA (United States)
4. Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA (United States)
5. Department of Medical Oncology, Dana-Farber/Brigham and Women's Cancer Center, Boston, MA (United States)

Purpose: To determine the risk of regional-nodal recurrence in patients with early-stage, invasive breast cancer, with clinically negative axillary nodes, who were treated with breast-conserving surgery, 'high tangential' breast radiotherapy, and hormonal therapy, without axillary surgery or the use of a separate nodal radiation field. Methods and Materials: Between September 1998 and November 2003, 74 patients who were {>=}55 years of age with Stage I-II clinically node-negative, hormone-receptor-positive breast cancer underwent tumor excision to negative margins without axillary surgery as a part of a multi-institutional prospective study. Postoperatively, all underwent high-tangential, whole-breast radiotherapy with a boost to the tumor bed, followed by 5 years of hormonal therapy. Results: For the 74 patients enrolled, the median age was 74.5 years, and the median pathologic tumor size was 1.2 cm. Lymphatic vessel invasion was present in 5 patients (7%). At a median follow-up of 52 months, no regional-nodal failures or ipsilateral breast recurrences had been identified (95% confidence interval, 0-4%). Eight patients died, one of metastatic disease and seven of other causes. Conclusion: In this select group of mainly older patients with early-stage hormone-responsive breast cancer and clinically negative axillary nodes, treatment with high-tangential breast radiotherapy and hormonal therapy, without axillary surgery, yielded a low regional recurrence rate. Such patients might be spared more extensive axillary treatment (axillary surgery, including sentinel node biopsy, or a separate nodal radiation field), with its associated time, expense, and morbidity.

• OSTI ID: 21128221
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 3 Vol. 72; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
BIOPSY
CARCINOMAS
DISEASE INCIDENCE
HORMONES
MAMMARY GLANDS
METASTASES
PATIENTS
RADIOTHERAPY
RECEPTORS
SURGERY