Conservative surgery with and without radiotherapy in elderly patients with early-stage breast cancer: a prospective randomised multicentre trial.
Breast conserving therapy (BCT) including postoperative irradiation of the remaining breast tissue is generally accepted as the best treatment for the majority of patients with early-stage breast cancer. The question is whether there is a necessity for irradiating all patients. Between 2001 and 2005, 749 women aged 55-75 years with infiltrating breast carcinoma were randomly assigned to breast conservative surgery, with or without radiotherapy (RT), to evaluate the incidence of in-breast recurrence (IBR). After 5 years of median follow-up, the cumulative incidence of IBR was 2.5% in the surgery-only arm and 0.7% in the surgery plus RT arm. There are no differences in terms of overall survival and distant disease-free survival. The preliminary evaluation suggests that breast irradiation after conservative surgery can be avoided without exposing these patients to an increased risk of distant-disease recurrence. Prolonged follow-up will further clarify the possible risks and late sequelae potentially induced by breast RT.
Tinterri
C
C
Breast Unit, Istituto Clinico Humanitas, via Manzoni 56, 20089 Rozzano, Milano, Italy.
Gatzemeier
W
W
Zanini
V
V
Regolo
L
L
Pedrazzoli
C
C
Rondini
E
E
Amanti
C
C
Gentile
G
G
Taffurelli
M
M
Fenaroli
P
P
Tondini
C
C
Sacchetto
G
G
Sismondi
P
P
Murgo
R
R
Orlandi
M
M
Cianchetti
E
E
Andreoli
C
C
D000368:Aged; D001943:Breast Neoplasms / Q000473:pathology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D015412:Mastectomy, Segmental; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology*; D018714:Radiotherapy, Adjuvant