Breast conservation among older patients with early-stage breast cancer: Locoregional recurrence following adjuvant radiation or hormonal therapy Journal Article
| Authors: | Tringale, K. R.; Berger, E. R.; Sevilimedu, V.; Wen, H. Y.; Gillespie, E. F.; Mueller, B. A.; McCormick, B.; Xu, A. J.; Cuaron, J. J.; Cahlon, O.; Khan, A. J.; Powell, S. N.; Morrow, M.; Heerdt, A. S.; Braunstein, L. Z. |
| Article Title: | Breast conservation among older patients with early-stage breast cancer: Locoregional recurrence following adjuvant radiation or hormonal therapy |
| Abstract: | Background: For patients with breast cancer undergoing breast-conserving surgery (BCS), adjuvant radiation (RT) and hormonal therapy (HT) reduce the risk of locoregional recurrence (LRR). Although several studies have evaluated adjuvant HT ± RT, the outcomes of HT versus RT monotherapy remain less clear. In this study, the risk of LRR is characterized among older patients with early-stage breast cancer following adjuvant RT alone, HT alone, neither, or both. Methods: This study included female patients from the Memorial Sloan Kettering Cancer Center (New York, New York) who were aged ≥65 years with estrogen receptor–positive (ER+)/human epidermal growth factor receptor 2–negative (HER2–) T1N0 breast cancer treated with BCS. The primary endpoint was time to LRR evaluated by Cox regression analysis. Results: There were 888 women evaluated with a median age of 71 years (range, 65-100 years) and median follow-up of 4.9 years (range, 0.0-9.5 years). There were 27 LRR events (3.0%). Five-year LRR was 11% for those receiving no adjuvant treatment, 3% for HT alone, 4% for RT alone, and 1% for HT and RT. LRR rates were significantly different between the groups (P <.001). Compared with neither HT nor RT, HT or RT monotherapy each yielded similar LRR reductions: HT alone (HR, 0.27; 95% CI, 0.10-0.68; P =.006) and RT alone (HR, 0.32; 95% CI, 0.11-0.92; P =.034). Distant recurrence and breast cancer–specific survival rates did not significantly differ between groups. Conclusions: LRR risk following BCS is low among women aged ≥65 years with T1N0, ER+/HER2– breast cancer. Adjuvant RT and HT monotherapy each similarly reduce this risk; the combination yields a marginal improvement. Further study is needed to elucidate whether appropriate patients may feasibly receive adjuvant RT monotherapy versus the current standards of HT monotherapy or combined RT/HT. © 2021 American Cancer Society |
| Keywords: | breast cancer; radiation therapy; hormonal therapy; breast-conserving surgery; locoregional recurrence; breast cancer–specific survival |
| Journal Title: | Cancer |
| Volume: | 127 |
| Issue: | 11 |
| ISSN: | 0008-543X |
| Publisher: | Wiley Blackwell |
| Date Published: | 2021-06-01 |
| Start Page: | 1749 |
| End Page: | 1757 |
| Language: | English |
| DOI: | 10.1002/cncr.33422 |
| PUBMED: | 33496354 |
| PROVIDER: | scopus |
| PMCID: | PMC8113065 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 1 June 2021 -- Source: Scopus |
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