Abstract OT2-04-01: Phase III trial to determine if chest wall and regional nodal radiotherapy (CWRNRT) post mastectomy (Mx) or the addition of RNRT to whole breast RT post breast-conserving surgery (BCS) reduces invasive breast cancer recurrence-free interval (IBCR-FI) in patients (pts) with pathologically positive axillary (PPAx) nodes who are ypN0 after neoadjuvant chemotherapy (NC): NRG Oncology/NSABP B-51/RTOG 1304

Mamounas, EP; Bandos, Hanna; White, JR; Julian, TB; Khan, AJ; Shaitelman, S.F.; Torres, M.; Fa, Vicini; Ganz, PA; McCloskey, S.A.; Paik, Soon Young; Gupta, Nilendu; Li, XA; DiCostanzo, DJ; Wj, Curran; Wolmark, N.

doi:10.1158/1538-7445.sabcs18-ot2-04-01

Cited by 9 publications

(11 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[17][18][19][20] The risk of secondary angiosarcoma provides further impetus to not irradiate most people older than 65 years, given the lack of clinical benefit. There is also evidence that radiotherapy can be omitted for younger postmenopausal women at low risk for recurrence, 21,22 and additional trials are ongoing to further evaluate the possibility of de-escalation of breast radiotherapy. 23 Even though most patients with angiosarcoma present with localized disease, the extent of damage is often substantial, necessitating complex reconstructive surgery.…”

Section: Discussionmentioning

confidence: 99%

Incidence and Presenting Characteristics of Angiosarcoma in the US, 2001-2020

Wagner,

Ravi,

Schaub

et al. 2024

JAMA Netw Open

View full text Add to dashboard Cite

ImportanceAngiosarcoma is an aggressive vascular malignant neoplasm presenting either as a primary or secondary cancer, often arising after radiotherapy or in the context of preexisting lymphedema. Comprehensive data describing its incidence and presentation patterns are needed.ObjectiveTo describe the incidence, presenting characteristics, and change over time of angiosarcoma in the US.Design, Setting, and ParticipantsThis retrospective cross-sectional study used data from the US Cancer Statistics (USCS) National Program of Cancer Registries–Surveillance, Epidemiology, and End Results Combined Database, which captures more than 99% of newly diagnosed cancers in the US. The study included all 19 289 patients in the US with a new diagnosis of angiosarcoma between 2001 and 2020 captured in the USCS database. Statistical analysis was performed from June to September 2023.Main Outcomes and MeasuresIncidence of angiosarcoma, demographics of patients with angiosarcoma, and extent of disease at presentation.ResultsThe study included 19 289 patients (median age, 71 years [IQR, 59-80 years]; 10 506 women [54.5%]) with a new diagnosis of angiosarcoma. The US incidence of angiosarcoma doubled between 2001 (657 cases) and 2019 (1312 cases), reflecting both an increase in the adjusted incidence rate of 1.6% per year (P = .001), to 3.3 cases per 1 000 000 person-years (95% CI, 3.1-3.5 cases per 1 000 000 person-years), and an increase in the population at risk. In 2020, the reported incidence rate (3.0 cases per 1 000 000 person-years) and cases of angiosarcoma (n = 1159) were modestly lower than in 2019. Overall, 72.3% of cases of angiosarcoma (n = 13 955) were cutaneous, subcutaneous, or breast angiosarcomas; 24.4% were visceral (n = 4701); and 3.3% were located in unknown or rare primary sites (n = 633). Secondary breast and chest wall angiosarcomas among women represented the largest contribution to increasing incidence. Among breast angiosarcomas, 99.2% (2684 of 2705) were in women and 71.9% (1944 of 2705) were secondary. A total of 80.4% of chest wall or thorax cases among women (1861 of 2316) were secondary vs 26.5% among men (112 of 422), and 63.9% of upper extremity cases among women (205 of 321) were secondary vs 26.8% (56 of 209) among men (P = .001). Rates of secondary angiosarcoma in the abdomen and lower extremities were similar between men and women. The incidence rate of visceral angiosarcoma was also found to be increasing (1.5% per year; P = .001).Conclusions and RelevanceThis cross-sectional study describes angiosarcoma presentation patterns and incidence rates in the US over a 20-year period and shows that the number of cases in men and women increased, with the greatest increase among women with secondary angiosarcoma of the chest, breast, and upper extremity. These data increase awareness of a rare but highly morbid disease and highlight the need for improved early detection of angiosarcoma among patients at high risk, such as women with a history of breast cancer.

show abstract

Section: Discussionmentioning

confidence: 99%

Incidence and Presenting Characteristics of Angiosarcoma in the US, 2001-2020

Wagner,

Ravi,

Schaub

et al. 2024

JAMA Netw Open

View full text Add to dashboard Cite

show abstract

“…Alternatively, the biopsied node can be clipped and retrieved at the time of SLN biopsy – the so-called targeted ALND ( 24 , 25 ). The ongoing NSABP B-51/RTOG 1304 and ATNEC trials will examine the role of RNI in ypN0 patients ( 26 , 27 ). The Dutch RAPCHEM;BOOG 2020-03 registry study is the first prospective evidence for the safety of selective de-escalation of radiation therapy after NACT for biopsy-proven clinically node positive T1-2N1 early breast cancers.…”

Section: Role Of Regional Radiotherapy In the Neo-adjuvant Eramentioning

confidence: 99%

“…This trial will determine whether SLN biopsy alone yields equivalent clinical outcomes to further axillary treatment (completion ALND or axillary irradiation) POSNOC has an in-built radiotherapy quality assurance programme coordinated by the UK Radiotherapy Trials Quality Assurance Group. The NSABP B-51/RTOG 1304 study will examine whether post-mastectomy radiotherapy combined with RNI or addition of RNI to breast RT following breast conserving surgery increases invasive breast cancer recurrence-free interval in cN1 patients converting to ypN0 after NACT ( 26 ). The ATNEC trial will randomize ypN0 patients to either observation only following SLN biopsy or further axillary treatment (completion ALND or axillary RT) ( 27 ).…”

Section: Concluding Commentsmentioning

confidence: 99%

The role of irradiation in the management of the axilla in early breast cancer patients

et al. 2023

View full text Add to dashboard Cite

The need for axillary radiotherapy in patients with invasive breast cancer (IBC) has been a topic of great debate in the last decade. Management of the axilla has evolved significantly over the past four decades with a trend towards de-escalation of surgical interventions and the aim of reducing morbidity and enhancing QOL without compromising long-term oncology outcomes. This review article will address the role of axillary irradiation with a focus on the omission of completion axillary lymph node dissection in selected patients with sentinel lymph node (SLN) positive early breast cancer (EBC) with reference to current guidelines based on evidence to date.

show abstract

“…More light on the feasibility of axillary de-escalation will be shed by ongoing phase III randomized trials in baseline cN+ patients undergoing PST followed by surgery including SLNB. The NSABP B-51/RTOG 1304 randomizes cT1-3pN1 patients who converted to ypN0 into RNI vs no RNI (NCT01872975) [74]. In the higher risk ypN+ population the ALLIANCE A011202 trial is evaluating omission of completion ALND in patients undergoing RNI (NCT01901094) [75].…”

Section: Tablementioning

confidence: 99%

De-escalation of axillary irradiation for early breast cancer – Has the time come?

Senkus

Cardoso

Kaidar‐Person

et al. 2021

Cancer Treatment Reviews

View full text Add to dashboard Cite

Introduction of sentinel lymph node biopsy, initially in clinically node-negative and subsequently in patients presenting with involved axilla and downstaged by primary systemic therapy, allowed for significant decrease in morbidity compared to axillary lymph node dissection. Concurrently, regional nodal irradiation was demonstrated to improve outcomes in most node-positive patients. Additionally, over the last decades, introduction of more effective systemic therapies has resulted in improvements not only at distant sites, but also in locoregional control, creating space for de-escalation of locoregional treatments. We discuss the data on de-escalation in axillary surgery and irradiation, both in patients undergoing upfront surgery and primary systemic therapy, with special emphasis on the feasibility of omission of nodal irradiation in patients undergoing primary systemic therapy. In view of the accumulating evidence, omission of axillary irradiation may be considered in clinically node-positive patients converting after primary systemic therapy to pathologically negative nodes on sentinel lymph node biopsy (preferably also with in-breast pCR), presenting with lower initial nodal stage, older age and were treated with breast-conserving surgery followed by whole breast irradiation. Omission of regional nodal irradiation in patients with aggressive tumor phenotypes achieving a pCR is under investigation. In patients undergoing preoperative endocrine therapy the adoption of axillary management strategies utilized in case of upfront surgery seems more suitable than those used in post chemotherapy-based primary systemic therapy setting.

show abstract

Cited by 9 publications

References 0 publications

Incidence and Presenting Characteristics of Angiosarcoma in the US, 2001-2020

Incidence and Presenting Characteristics of Angiosarcoma in the US, 2001-2020

The role of irradiation in the management of the axilla in early breast cancer patients

De-escalation of axillary irradiation for early breast cancer – Has the time come?

Contact Info

Product

Resources

About