title: Local control, toxicity, and cosmesis in women >70 years enrolled in the American Society of Breast Surgeons accelerated partial breast irradiation registry trial.
abstract: OBJECTIVE
  The American Society of Breast Surgeons enrolled women in a registry trial to prospectively study patients treated with the MammoSite Radiation Therapy System breast brachytherapy device. The present report examined the outcomes in women aged >70 years enrolled in the trial.
  
  
  METHODS
  A total of 1,449 primary early stage breast cancers were treated in 1,440 women. Of these, 537 occurred in women >70 years old. Fisher's exact test was performed to correlate age (≤ 70 vs. >70 years) with toxicity and with cosmesis. The association of age with local recurrence (LR) failure times was investigated by fitting a parametric model.
  
  
  RESULTS
  Older women were less likely to develop telangiectasias than younger women (7.9% vs. 12.4%, p = 0.0083). The incidence of other toxicities was similar. Cosmesis was good or excellent in 92% of the women >70 years old. No significant difference was found in LR as a function of age. The 5-year actuarial LR rate with invasive disease for the older vs. younger population was 2.79% and 2.92%, respectively (p = 0.5780). In women >70 years with hormone-sensitive tumors ≤ 2 cm who received hormonal therapy (n = 195), the 5-year actuarial rate of LR, overall survival, disease-free survival, and cause-specific survival was 2.06%, 89.3%, 87%, and 97.5%, respectively. These outcomes were similar in women who did not receive hormonal therapy. Women with small, estrogen receptor-negative disease had worse LR, overall survival, and disease-free survival compared with receptor-positive patients.
  
  
  CONCLUSIONS
  Accelerated partial breast irradiation with the MammoSite radiation therapy system resulted in low toxicity and produced similar cosmesis and local control at 5 years in women >70 years compared with younger women. This treatment should be considered as an alternative to omitting adjuvant radiotherapy for older women with small-volume, early-stage breast cancer.
authors.affiliation: Robert Wood Johnson University Hospital, Cancer Institute of New Jersey, New Brunswick, NJ 08901, USA. atif_khan@rwjuh.edu
authors.forename: Atif J
authors.initials: AJ
authors.lastname: Khan
authors.forename: Frank A
authors.initials: FA
authors.lastname: Vicini
authors.forename: Peter
authors.initials: P
authors.lastname: Beitsch
authors.forename: Sharad
authors.initials: S
authors.lastname: Goyal
authors.forename: Henry M
authors.initials: HM
authors.lastname: Kuerer
authors.forename: Martin
authors.initials: M
authors.lastname: Keisch
authors.forename: Coral
authors.initials: C
authors.lastname: Quiet
authors.forename: Victor
authors.initials: V
authors.lastname: Zannis
authors.forename: Angela
authors.initials: A
authors.lastname: Keleher
authors.forename: Howard
authors.initials: H
authors.lastname: Snyder
authors.forename: Mark
authors.initials: M
authors.lastname: Gittleman
authors.forename: Pat
authors.initials: P
authors.lastname: Whitworth
authors.forename: Richard
authors.initials: R
authors.lastname: Fine
authors.forename: Maureen
authors.initials: M
authors.lastname: Lyden
authors.forename: Bruce G
authors.initials: BG
authors.lastname: Haffty
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D001918:Brachytherapy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D001940:Breast / Q000098:blood supply; D001943:Breast Neoplasms / Q000453:epidemiology / Q000473:pathology / Q000532:radiotherapy*; D018572:Disease-Free Survival; D004954:Esthetics; D005260:Female; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D016609:Neoplasms, Second Primary; D012042:Registries; D013684:Telangiectasis / Q000209:etiology; D047368:Tumor Burden; D014481:United States
chemical_list: D018931:Antineoplastic Agents, Hormonal