Prognostic factors in patients undergoing curative irradiation for breast cancer

Nobler, Myron P.; Venet, Louis

doi:10.1016/0360-3016(85)90248-2

Cited by 40 publications

(9 citation statements)

References 9 publications

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“…However, other studies have found no difference in local recurrence rates when patients younger than 50 years were compared with those older than 50 years. 30 Our previous study 9 and the study reported here both demonstrated that age Ͼ 50 years was independently associated with decreased risk of IBTR. However, we also demonstrate here that the IBTR rate among patients aged Յ 50 years improved dramatically after 1994 and became similar to the IBTR rate among patients aged Ͼ 50 years.…”

Section: Discussionsupporting

confidence: 51%

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Improving local control with breast‐conserving therapy

Cabıoğlu

Hunt

Buchholz

et al. 2005

Cancer

101

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BACKGROUNDThe risk of ipsilateral breast tumor recurrence (IBTR) after breast‐conserving therapy (BCT) is associated with treatment and tumor‐related variables, such as surgical margin status and the use of systemic therapy, and these variables have changed over time. Correspondingly, the authors of the current study hypothesized that the contemporary multidisciplinary management of breast carcinoma would lead to an improvement in IBTR rates after BCT.METHODSBetween 1970 and 1996, 1355 patients with pathologic Stage I‐II invasive breast carcinoma underwent BCT (breast‐conserving surgery and adjuvant radiation therapy) at The University of Texas M. D. Anderson Cancer Center. Contemporary methods of analyzing surgical margins were in routine use by 1994. To analyze the effect of this variable and others, patient and tumor characteristics and IBTR rates in patients treated during 1994–1996 were compared with those in patients treated from 1970 to 1993.RESULTSCharacteristics were similar in patients treated during 1994–1996 (n = 381) and those treated before 1994 (n = 974) except for patients aged >50 years (63.3% vs. 51.7%, P < 0.001), and patients who had a family history of breast carcinoma (37.9% vs. 30.8%, P = 0.017). Patients treated after 1994 were less likely to have positive or unknown margins (2.9 % vs. 24.1 %, P = 0.0001), more likely to receive chemotherapy (40.5% vs. 26%, P < 0.001), and more likely to receive hormonal therapy (33.3% vs. 19.4%, P < 0.001), but less likely to receive radiation boosts to the primary tumor bed (59.8% vs. 89%, P < 0.001). The 5‐year cumulative IBTR rate was significantly lower among patients treated in 1994–1996 than among patients treated before 1994 (1.3% vs. 5.7%, P = 0.001) largely because of the drop in IBTR rates among patients aged ≤ 50 years (1.4 % vs. 9.1 %, P = 0.0001). On multivariate analysis, age > 50 (hazards ratio [HR] = 0.401; P = 0.0001), presence of negative surgical margins (HR = 0.574; P = 0.017), and use of adjuvant hormonal therapy (HR = 0.402; P = 0.05) were independent predictors of improved 5‐year IBTR‐free survival. On subgroup analysis, use of chemotherapy was associated with increased IBTR‐free survival among women aged ≤ 50 years (HR = 0.383; P = 0.001). Although 5‐year cumulative IBTR rates were lower among women aged > 50 years than among younger women before 1994 (2.6 % vs. 9.1%, P < 0.0001), no such difference was found in the group treated in 1994–1996 (1.2 % for age > 50 yrs vs. 1.4 % for ≤ 50 yrs, P = 0.999).CONCLUSIONSThe IBTR rate after BCT appears to be declining, especially among patients < 50 years of age. However, long‐term follow‐up is necessary to confirm this finding. This finding may reflect changes in surgical approaches and pathologic evaluation as well as an increased use of systemic therapy. The current low incidence of IBTR with multidisciplinary management of breast carcinoma may result in more patients choosing BCT over mastectomy. Cancer 2005. © 2005 American Cancer Society.

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Section: Discussionsupporting

confidence: 51%

“…51.7%, P Ͻ 0.001), and patients who had a family history of breast carcinoma (37.9% vs. 30.8%, P ϭ 0.017). Patients treated after 1994 were less likely to have positive or unknown margins (2.9 % vs. 24.1 %, P ϭ 0.0001), more likely to receive chemotherapy (40.5% vs. 26%, P Ͻ 0.001), and more likely to receive hormonal therapy (33.3% vs.…”

Section: Resultsmentioning

confidence: 99%

Improving local control with breast‐conserving therapy

Cabıoğlu

Hunt

Buchholz

et al. 2005

Cancer

101

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“…In this context, other authors have demonstrated that young age increased LR risk [10,23]. Some studies have found no significant differences in LR rates when women <50 years were compared with women >50 years old [24]. In our study, we considered three age groups: women <50 years old, 50-64 years old and ‡ 64 years old.…”

Section: Discussionmentioning

confidence: 95%

Predictors of local recurrence after conservative surgery and whole-breast irradiation

Cèfaro

Genovesi

Marchese

et al. 2006

Breast Cancer Res Treat

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“…Six small studies [75]–[80], with a total of 153 cases, found that the local recurrence rate in the vicinity of the primary lesion was 83%, demonstrating that the majority of recurrences were in the vicinity of the tumor bed [81]. Pathologic studies also demonstrated that for most patients, the majority of foci in the breast were quite close to the primary lesion [82].…”

Section: The Status Of High-intensity Focused Ultrasound Therapy For mentioning

confidence: 99%

Magnetic resonance image-guided versus ultrasound-guided high-intensity focused ultrasound in the treatment of breast cancer

Sheng¹,

Wu²

2013

Chin J Cancer

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Image-guided high-intensity focused ultrasound (HIFU) has been used for more than ten years, primarily in the treatment of liver and prostate cancers. HIFU has the advantages of precise cancer ablation and excellent protection of healthy tissue. Breast cancer is a common cancer in women. HIFU therapy, in combination with other therapies, has the potential to improve both oncologic and cosmetic outcomes for breast cancer patients by providing a curative therapy that conserves mammary shape. Currently, HIFU therapy is not commonly used in breast cancer treatment, and efforts to promote the application of HIFU is expected. In this article, we compare different image-guided models for HIFU and reviewed the status, drawbacks, and potential of HIFU therapy for breast cancer.

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Prognostic factors in patients undergoing curative irradiation for breast cancer

Cited by 40 publications

References 9 publications

Improving local control with breast‐conserving therapy

Improving local control with breast‐conserving therapy

Predictors of local recurrence after conservative surgery and whole-breast irradiation

Magnetic resonance image-guided versus ultrasound-guided high-intensity focused ultrasound in the treatment of breast cancer

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