Adjuvant trastuzumab reduces locoregional recurrence in women who receive breast-conservation therapy for lymph node-negative, human epidermal growth factor receptor 2-positive breast cancer Journal Article
| Authors: | Kiess, A. P.; Mcarthur, H. L.; Mahoney, K.; Patil, S.; Morris, P. G.; Ho, A.; Hudis, C. A.; McCormick, B. |
| Article Title: | Adjuvant trastuzumab reduces locoregional recurrence in women who receive breast-conservation therapy for lymph node-negative, human epidermal growth factor receptor 2-positive breast cancer |
| Abstract: | Background: Patients with human epidermal growth factor receptor 2 (HER2)-positive breast cancer have a higher risk of locoregional recurrence (LRR), even in the setting of early stage, lymph node-negative disease. In this sequential, retrospective study, the authors evaluated whether adjuvant trastuzumab was associated with reduced LRR in women with lymph node-negative, HER2-positive disease who received breast-conservation therapy (BCT). Methods: By using an institutional database, 197 women were identified who had lymph node-negative, HER2-positive breast cancer measuring >5 cm diagnosed between 2002 and 2008 and who received BCT, including whole-breast irradiation. Two cohorts were compared: 70 women who did not receive trastuzumab (the no-trastuzumab cohort) and 102 women who did receive trastuzumab (the trastuzumab cohort). Kaplan-Meier methods were used to estimate LRR-free survival. Results: The 2 cohorts were similar in age, tumor size, histology, and hormone receptor status. Chemotherapy was received by 73% of the no-trastuzumab cohort and by 100% of the trastuzumab cohort. In both groups, 99% of patients completed radiotherapy with a median dose of 60 Gray. The median recurrence-free follow-up was 86 months for the no-trastuzumab cohort and 47 months for the trastuzumab cohort. The 3-year LRR-free survival rate was 90% (95% confidence interval, 83%-97%) for the no-trastuzumab cohort and 99% (95% confidence interval, 97%-100%) for the trastuzumab cohort. In the no-trastuzumab cohort, LRR occurred in 7 patients (median time to LRR, 14 months). In the trastuzumab cohort, there was 1 LRR at 14 months. Conclusions: Even among women with lower risk breast cancer, the relatively high locoregional failure rates associated with positive HER2 status could be reduced markedly with adjuvant trastuzumab chemotherapy. Within 3 years, a 10% LRR rate without trastuzumab and a 1% LRR rate with trastuzumab were observed in women with lymph node-negative disease who received BCT. © 2011 American Cancer Society. |
| Keywords: | breast cancer; recurrence; trastuzumab; breast conservation; locoregional |
| Journal Title: | Cancer |
| Volume: | 118 |
| Issue: | 8 |
| ISSN: | 0008-543X |
| Publisher: | Wiley Blackwell |
| Date Published: | 2012-04-15 |
| Start Page: | 1982 |
| End Page: | 1988 |
| Language: | English |
| DOI: | 10.1002/cncr.26484 |
| PROVIDER: | scopus |
| PUBMED: | 21887681 |
| DOI/URL: | |
| Notes: | --- - "Export Date: 1 May 2012" - "CODEN: CANCA" - "Source: Scopus" |
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