Omission of postoperative radiotherapy after breast-conserving surgery in low-risk breast cancer

Sofia Palmér, Antonis Valachis, Henrik Lindman, Daniel Robert Smith, Åsa Wickberg, Fredrika Killander, Judith Bjöhle, Zakaria Einbeigi, Greger Nilsson, Johan Ahlgren, Kenneth Villman
{"title":"Omission of postoperative radiotherapy after breast-conserving surgery in low-risk breast cancer","authors":"Sofia Palmér, Antonis Valachis, Henrik Lindman, Daniel Robert Smith, Åsa Wickberg, Fredrika Killander, Judith Bjöhle, Zakaria Einbeigi, Greger Nilsson, Johan Ahlgren, Kenneth Villman","doi":"10.1093/jnci/djae315","DOIUrl":null,"url":null,"abstract":"Background This prospective cohort study aimed to assess whether postoperative radiotherapy could safely be omitted in women ≥ 65 years with low-risk, estrogen receptor (ER)-positive T1N0 breast cancer treated with breast-conserving surgery and adjuvant endocrine therapy. Methods Eligible patients were women ≥ 65 years with unifocal, non-lobular, grade 1 or 2, ER-positive, pT1N0 breast cancer treated with breast-conserving surgery and endocrine therapy for five years. Patients were followed up with mammography at least annually for 10 years. The primary endpoint was local recurrence. Secondary endpoints were contralateral breast cancer, recurrence-free survival, and overall survival. Results The final study cohort included 601 patients with a median age of 71 years (range: 65 to 90 years) and a median tumor size of 11 mm (range: 3 to 20 mm). Median follow-up time was 119 months (interquartile range: 103 to 121 months). The cumulative incidence of local recurrence was 1.5% (95% confidence interval (CI): 0.8 to 2.8%) and 5.5% (95% CI: 3.8 to 7.6%) at 5 and 10 years, respectively. The cumulative incidence of contralateral breast cancer was 1.7% (95% CI: 0.9 to 3.0%) at 5 years and 4.5% (95% CI: 3.0 to 6.6%) at 10 years. The overall survival rate at 10 years was 83.1% (95% CI: 80.8 to 85.4%). In total, three patients (0.5%) died due to breast cancer. Conclusion Our results support the possibility to omit radiotherapy after breast-conserving surgery in a well-defined subgroup of women aged ≥ 65 years with low-risk, ER-positive, pT1N0 breast cancer receiving adjuvant endocrine therapy.","PeriodicalId":501635,"journal":{"name":"Journal of the National Cancer Institute","volume":"12 1","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of the National Cancer Institute","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1093/jnci/djae315","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0

Abstract

Background This prospective cohort study aimed to assess whether postoperative radiotherapy could safely be omitted in women ≥ 65 years with low-risk, estrogen receptor (ER)-positive T1N0 breast cancer treated with breast-conserving surgery and adjuvant endocrine therapy. Methods Eligible patients were women ≥ 65 years with unifocal, non-lobular, grade 1 or 2, ER-positive, pT1N0 breast cancer treated with breast-conserving surgery and endocrine therapy for five years. Patients were followed up with mammography at least annually for 10 years. The primary endpoint was local recurrence. Secondary endpoints were contralateral breast cancer, recurrence-free survival, and overall survival. Results The final study cohort included 601 patients with a median age of 71 years (range: 65 to 90 years) and a median tumor size of 11 mm (range: 3 to 20 mm). Median follow-up time was 119 months (interquartile range: 103 to 121 months). The cumulative incidence of local recurrence was 1.5% (95% confidence interval (CI): 0.8 to 2.8%) and 5.5% (95% CI: 3.8 to 7.6%) at 5 and 10 years, respectively. The cumulative incidence of contralateral breast cancer was 1.7% (95% CI: 0.9 to 3.0%) at 5 years and 4.5% (95% CI: 3.0 to 6.6%) at 10 years. The overall survival rate at 10 years was 83.1% (95% CI: 80.8 to 85.4%). In total, three patients (0.5%) died due to breast cancer. Conclusion Our results support the possibility to omit radiotherapy after breast-conserving surgery in a well-defined subgroup of women aged ≥ 65 years with low-risk, ER-positive, pT1N0 breast cancer receiving adjuvant endocrine therapy.
低危乳腺癌保乳术后放疗的遗漏
本前瞻性队列研究旨在评估≥65岁低危、雌激素受体(ER)阳性T1N0乳腺癌患者接受保乳手术和辅助内分泌治疗后是否可以安全省略术后放疗。方法:年龄≥65岁的单灶性、非小叶性、1级或2级、er阳性、pT1N0型乳腺癌患者接受保乳手术和内分泌治疗5年。患者至少每年接受乳房x光检查随访10年。主要终点为局部复发。次要终点为对侧乳腺癌、无复发生存期和总生存期。最终研究队列包括601例患者,中位年龄为71岁(范围:65至90岁),中位肿瘤大小为11 mm(范围:3至20 mm)。中位随访时间为119个月(四分位数范围:103 ~ 121个月)。5年和10年的累积局部复发率分别为1.5%(95%可信区间(CI): 0.8 ~ 2.8%)和5.5% (95% CI: 3.8 ~ 7.6%)。5年对侧乳腺癌的累积发病率为1.7% (95% CI: 0.9 - 3.0%), 10年对侧乳腺癌的累积发病率为4.5% (95% CI: 3.0 - 6.6%)。10年总生存率为83.1% (95% CI: 80.8 ~ 85.4%)。总共有3名患者(0.5%)死于乳腺癌。结论:我们的研究结果支持在年龄≥65岁的低危、er阳性、pT1N0乳腺癌患者接受辅助内分泌治疗的保乳手术后省略放疗的可能性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
自引率
0.00%
发文量
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信