O-12 Radiation therapy after breast-conserving surgery: randomised trial in patients with low risk of recurrence

Radiotherapy or tamoxifen after conserving surgery for breast cancers of excellent prognosis: British Association of Surgical Oncology (BASO) II trial

“…Although ER status is not available in this series, it is highly likely that the vast majority have strongly ER positive disease (given that they are grade 1 or defined special type) and it is likely that tamoxifen may be particularly effective in this group. In both this (BASO II) and the GBSG trials 8 of tumours with good prognoses, LR was reduced to one third of the level seen in women given neither tamoxifen nor RT. Similarly, in the present trial, LR reaches negligible levels by the application of both, as in the Canadian trial 17 .…”

“…Previous studies [1][2][3][4][5][6][7][8] have all shown a marked reduction from the application of radiotherapy (RT) to the risk of local recurrence (LR) following breast-conserving surgery. Although the overall absolute risk level without RT has been reported as high as 20% -40%, this still means that the majority do not suffer LR.…”

Omission of radiation therapy after breast‐conserving surgery in the United States

“…Several randomized trials have demonstrated that local recurrence rates are significantly higher if RT is omitted after BCS. 2,[4][5][6][7][8][9] In a recent meta-analysis, the EBCTCG estimated that the absolute 5-year local recurrence risk is 19% lower for women who receive RT after BCS, and the absolute benefit was greater in younger women. 10 In our population-based analysis, we observed that the group of women who are most likely to benefit from RT is the same group that had significantly lower rates of RT.…”

“…2,3 Several randomized trials have demonstrated that local recurrence rates are significantly higher for patients who undergo BCS without RT. 2,[4][5][6][7][8][9] The overview analysis from the Early Breast Cancer Trialists' Collaborative Group (EBCTCG) recently reported that breast cancer mortality rates also were significantly higher for patients who did not receive RT after BCS. 10 The patterns of surgical treatment for stage I and II breast cancer changed after the National Institutes of Health Consensus Conference.…”

“Simplicity is complexity resolved”: the case of postoperative radiation therapy after breast conservation

“…The importance of endocrine therapy in patients having WBRT omitted was shown in the German Breast Study Group (GBSG) trial, where the crude risk of local recurrence at 10 years was 7-10% in patients treated either with BCS and WBRT, BCS and tamoxifen, or BCS and both, but was 34% in those treated with BCS alone (16). However, as treatment safety and quality of life are also crucial endpoints, we should also question the need for adjuvant systemic therapy in low-risk EBC.…”