Omission of adjuvant radiation therapy in elderly patients with low risk breast cancer undergoing breast-conserving surgery - two center experience

Abstract

Introduction. Breast cancer is, now often diagnosed in patients older than 70 years due to longer life expectancy. The usual treatment is mastectomy to obviate radiotherapy or breast-conserving surgery followed by radiotherapy. The aim of this study was to investigate the need for adjuvant radiotherapy in older patients and the consequences of omitting radiotherapy following conservative surgery.Methods. An extensive database search was made of patients who had been treated for breast cancer at the Department of Oncology, University Hospital Olomouc and the Atlas Hospital in Zlin (2004Zlin ( -2008. We identified 738 patients of whom 190 patients (25.7%) were older than 70 years of age. These were followed up for progression-free and overall survival. The cause of death was checked for breast cancer relapse. Results. In total only 9 patients undergoing breast saving surgery were ultimately identified. No patient had confirmed local recurrence during the follow up period: Two patients have died due to distant metastasis without local relapse and one patient has died for reasons other than breast cancer. Conclusion. Omitting radiotherapy after breast saving surgery provides an opportunity for women to undergo breast saving surgery and avoid 7 weeks of radiotherapy. This could significantly improve patient quality of life. In our of many years experience and from published randomized data, this procedure is safe for a select group of patients 70 years of age and older.

Prognostic Influence of Internal Mammary Node Drainage in Patients with Early-stage Breast Cancer

“…The approach to axillary lymph nodes in early-stage breast cancer management is quite straightforward based on robust data from clinical trials which clearly shift towards less radical treatment. Extensive local treatment seems to have little effect on patient oncological outcome but significantly increases morbidity and the cost of treatment (2)(3)(4)(5)(6)(7)(8)(9). Unfortunately, the situation for drainage of IMNs may be viewed differently.…”

Significance of resection margin as a risk factor for local control of early stage breast cancer

“…The other important question is, however, whether obtaining free resection margin will have an impact on local recurrence rate and subsequently on overall survival of breast cancer patients [19][20][21][22][23][24][25][26][27] . All patients undergoing breast conserving surgery are indicated for adjuvant radiotherapy (considering that adjuvant radiotherapy may be omitted in older patients 28 ). The effect of adjuvant radiotherapy for local tumor control is supported by a large number of randomized trials and its role currently seems to be unquestionable 29 .…”

Correlação da dor e qualidade de vida de mulheres pós-tratamento cirúrgico de câncer de mama

“…Esse processo pode ser agravado pela apreensão dos familiares sobre a realização das atividades domésticas, mesmo que elas estejam aptas para tal 26 . Evidências mostram que indivíduos que tiveram câncer de mama não realizam atividade física regular, sendo o principal desafio a realização de atividade atraente e eficaz, de forma sustentável e rentável 27 .…”