Comparison between the risk of ipsilateral breast tumor recurrence after breast-conserving surgery in early breast cancer cases treated by whole breast irradiation with and without boost in patients ≥ 50 years old

Abstract

Background : Breast-conserving therapy (BCT) is the standard treatment for early breast cancer (BC). Radiotherapy after breast-conserving surgery (BCS) decreases the local recurrence and reduces mortality. Being young is documented as an important poor prognostic factor for disease control. Boost irradiation induces some pitfalls, including moderate to severe fibrosis, impaired cosmoses, and the higher cost of an additional boost therapy. Patient and Methods : It is a multicentric retrospective comparative study done at the Clinical Oncology and Nuclear Medicine Department, University Hospital and and unit at of Egypt from January 2016 to December 2017. We analyzed 120 cases of early BC patients with negative margins and low-grade tumors after BCS. They were treated with whole-breast irradiation (WBI) without (group A) and with (group B) boost. Results : The median follow-up was 44 months. The local recurrences occur only in 2 cases (3%) and 3 cases (5%) of groups A and B respectively (P = 0.6). Distant metastasis were found in 2 cases (3%) and 4 cases (7%) of group A and B respectively (P = 0.3). The mean overall survival (OS) was 52.8 and 53.2 months for groups A & B respectively (P = 0.6). The mean disease-free survival (DFS) was 54.6 and 52.1 months for groups A and B respectively (P = 0.3). Conclusion : We did not find any difference between boost and no boost radiotherapy after BCS in patients ≥50 years old with early BC regarding local failure, DFS and OS.