title: Treatment sequence of aromatase inhibitors and radiotherapy and long-term outcomes of breast cancer patients.
abstract: BACKGROUND
  The optimal sequence of radiotherapy (RT) and hormone therapy using aromatase inhibitors (AI) in patients with breast cancer treated with breast-conserving surgery is unclear. Several short-term analyses have shown that there are no differences in breast cancer outcomes according to the treatment sequence. However, long-term outcomes have not been reported.
  
  
  METHODS
  We retrospectively analyzed disease-free survival events in 315 consecutive breast cancer patients who underwent breast-conserving surgery, RT, and received adjuvant AI at our Institute between 2001 and 2009. We compared the outcomes between treatment sequences of AI and RT (concurrent vs. sequential).
  
  
  RESULTS
  With a median follow-up of 5.6 years, no significant differences between the 2 groups in terms of disease-free survival (unadjusted p=0.6; adjusted p=0.5) were observed.
  
  
  CONCLUSIONS
  Similarly to previous short-term reports, AI administration after RT and AI concurrently with RT are both reasonable treatment options for early-stage breast cancer patients treated with breast-conserving surgery.
authors: Department of Breast and Endocrine Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan isitobi-ma@mc.pref.osaka.jp.
authors: Makoto
authors: M
authors: Ishitobi
authors: Department of Breast and Endocrine Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan.
authors: Mizuho
authors: M
authors: Shiba
authors: Department of Breast and Endocrine Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan.
authors: Takahiro
authors: T
authors: Nakayama
authors: Department of Breast and Endocrine Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan.
authors: Kazuyoshi
authors: K
authors: Motomura
authors: Department of Breast and Endocrine Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan.
authors: Hiroki
authors: H
authors: Koyama
authors: Department of Radiation Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan.
authors: Kinji
authors: K
authors: Nishiyama
authors: Department of Breast and Endocrine Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan.
authors: Yasuhiro
authors: Y
authors: Tamaki
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D047072:Aromatase Inhibitors / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000401:mortality / Q000628:therapy*; D059248:Chemoradiotherapy; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008875:Middle Aged; D012189:Retrospective Studies
chemical_list: D047072:Aromatase Inhibitors
keywords: Sequence; aromatase inhibitor; hormone therapy; long-term outcome; radiotherapy