Breast Cancer Research News
Holli K et al. Radiotherapy After Segmental Resection of Breast Cancer With Favorable Prognostic Features: 12-Year Follow-Up Results of a Randomized Trial. J Clin Oncol. 2008 Dec 29. [Epub ahead of print]
Holli K and colleagues investigated the benefits of radiotherapy (RT) in 264 women older than 40 years who were treated by breast resection with >/= 1 cm of tumor-free margin and axillary nodal dissection and were randomly assigned to receive or not to receive RT (the cumulative dose was 50 Gy) after surgery. All patients had T1N0M0 ER+ve tumours. Furthermore, the tumours were well to moderately differentiated and unifocal, and of low cell proliferation rate (ie, S phase fraction </= 7% or nuclear Ki-67 expression < 10%) and had to lack an extensive intraductal component. After a median follow-up time of 12.1 years, the authors observed 16 (11.6%) and 34 (27.2%) local recurrences in the RT and the control arms, respectively (P = .0013). Time to local recurrence was longer in the RT arm (hazard ratio [HR], 0.36; 95% CI, 0.20 to 0.65; P = .00071). Twenty-one patients assigned to radiotherapy and 26 assigned to control died during the follow-up. There were no differences in overall survival time (HR, 0.63; 95% CI, 0.35 to 1.12; P = .11), distant disease-free survival (P = .94), or breast cancer-specific survival (P = .56) between the RT and control groups. This study provides further evidence that RT reduces the incidence of ipsilateral breast recurrence, even among women with good prognosis small-size breast tumours excised with a minimal surgical margin of 1cm. However, RT did not significantly improve survival.