Failure pattern and survival after breast conserving therapy. Long-term results of the Danish Breast Cancer Group (DBCG) 89 TM cohort

Lyngholm, Christina D; Laurberg, Tinne; Alsner, Jan; Damsgaard, Tine Engberg; Overgaard, Jens; Christiansen, Peer

doi:10.3109/0284186x.2016.1156741

Cited by 17 publications

(11 citation statements)

References 45 publications

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“…Additionally, clarifying the pattern of recurrence is helpful for determining an adjuvant therapy schedule. Our study found that recurrence at a distant site was the main failure pattern for patients with early stage breast cancer, which is consistent with the literatures (26,27), indicating the value of systemic therapy. Specifically, we found that delaying the initiation of chemotherapy beyond 12 weeks after BCS has an independently significant adverse effect on clinical endpoints after balancing these potential confounders by multivariable analysis.…”

Section: Discussionsupporting

confidence: 93%

Timing of Chemotherapy and Radiotherapy Following Breast-Conserving Surgery for Early-Stage Breast Cancer: A Retrospective Analysis

et al. 2020

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Purpose: To investigate the effect of chemotherapy and radiotherapy timing after breast conserving surgery (BCS) on recurrence and survival of women with early-stage breast cancer. Patients and Methods: We retrospectively analyzed 900 patients who underwent BCS followed by both adjuvant chemotherapy and radiotherapy. Of these, 488 women received chemotherapy first (CT-first group) while the other 412 received radiotherapy first (RT-first group). Locoregional recurrence (LRR), distant metastasis (DM), diseasefree survival (DFS), and overall survival (OS) rates were calculated using the Kaplan-Meier method and further confirmed with propensity-score matching (PSM) and the Cox proportional hazards model. The optimal cutoff value of interval time from surgery to the start of chemotherapy was calculated by Maxstat. Results: The median follow-up was 7.1 years. In pre-match analysis, the CT-first group had a significantly higher 8-year DFS than the RT-first group (90.4% vs. 83.1%, P = 0.005). PSM analysis of 528 patients indicated that the 8-year DFS (91.0% vs. 83.3%, P = 0.005) and DM (8.6% vs. 14.6%, P = 0.017) were significantly better in the CT-first group, but that the OS (P = 0.096) and LRR (P = 0.434) were similar. We found the optimal cutoff value of interval from surgery to chemotherapy was 12 weeks. Patients starting chemotherapy later than 12 weeks after surgery had significantly inferior survival outcomes. Conclusion: For women with breast cancer who require both chemotherapy and radiotherapy after BCS, adjuvant chemotherapy should be started within 12 weeks. Delaying the initiation of radiotherapy, for administration of long-course chemotherapy, does not compromise outcomes.

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Section: Discussionsupporting

confidence: 93%

Timing of Chemotherapy and Radiotherapy Following Breast-Conserving Surgery for Early-Stage Breast Cancer: A Retrospective Analysis

et al. 2020

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“…The results obtained by BCS and radiotherapy in the DBCG 82TM trial were confirmed in a successive DBCG 89 cohort with similar recurrence and mortality at 20 years [37]. In a small long-term study with a median of 12 years follow-up 88% of the patients were satisfied with their cosmetic outcome, and poor cosmesis was correlated with use of chemotherapy, large breast size and smoking [38].…”

Section: Long-term Outcome and Morbidity After Loco-regional Therapymentioning

confidence: 71%

Forty years of landmark trials undertaken by the Danish Breast Cancer Cooperative Group (DBCG) nationwide or in international collaboration

et al. 2017

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“…Our analysis was not based on data from a randomized clinical trial wherefore selection bias and confounding may exist, leading to divergent results as demonstrated when SEER observational data were compared with randomized data [40]. However, a study evaluating the implementation of BCT as a routine procedure in Denmark (DBCG 89-program) displayed an equal failure pattern and improved survival in comparison with women from the clinical randomized DBCG 82 tm protocol evaluating BCT vs. mastectomy [41]. The procedure for data collecting used in this study, was also used in the present study.…”

Section: Discussionmentioning

confidence: 99%

Long-term age-dependent failure pattern after breast-conserving therapy or mastectomy among Danish lymph-node-negative breast cancer patients

Laurberg

Lyngholm

Christiansen

et al. 2016

Radiotherapy and Oncology

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Failure pattern and survival after breast conserving therapy. Long-term results of the Danish Breast Cancer Group (DBCG) 89 TM cohort

Cited by 17 publications

References 45 publications

Timing of Chemotherapy and Radiotherapy Following Breast-Conserving Surgery for Early-Stage Breast Cancer: A Retrospective Analysis

Timing of Chemotherapy and Radiotherapy Following Breast-Conserving Surgery for Early-Stage Breast Cancer: A Retrospective Analysis

Forty years of landmark trials undertaken by the Danish Breast Cancer Cooperative Group (DBCG) nationwide or in international collaboration

Long-term age-dependent failure pattern after breast-conserving therapy or mastectomy among Danish lymph-node-negative breast cancer patients

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