Radiation therapy after breast-conserving surgery

Shigematsu, Naoyuki; Takeda, Atsuya; Sanuki, Naoko; Fukada, Junichi; Umemura, Takashi; Ito, Hisao; Kawaguchi, Osamu; Kunieda, Etsuo; Kubo, Atsushi

doi:10.1007/s11604-005-0021-y

Cited by 4 publications

(4 citation statements)

References 118 publications

(107 reference statements)

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“…While the techniques and modalities used in this field are constantly changing, the fact remains that any type of radiation therapy poses downstream risks to the patient. While radiation therapy for breast cancer is generally very well-tolerated, it does pose the risk for multiple acute and chronic side effects [10][11][12][13], including an increased risk for cancer within the irradiated tissue. In breast cancer patients, this risk has been estimated at approximately 1%, and becomes detectable after at least 5 years of follow-up [14].…”

Section: Discussionmentioning

confidence: 99%

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Breast Radiation Correlates with Side of Parathyroid Adenoma

Woll¹,

Mazeh²,

Anderson

et al. 2011

World j. surg.

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The present study demonstrates that, similar to prior head and neck radiation, prior breast irradiation correlates with the development of parathyroid disease. Specifically, there is a strong correlation between the side of the radiation therapy and the side of a subsequent parathyroid adenoma. Breast irradiation should therefore be considered a risk factor for the development of parathyroid adenomas.

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Section: Discussionmentioning

confidence: 99%

“…Irradiation for breast cancer is associated with numerous side effects, including fatigue, skin irritation, rib fractures, radiation pneumonitis, cardiac toxicity, and myelosupression [10][11][12][13]. Breast irradiation has also been associated with an increased risk of cancer of the skin, muscle, lung, and soft tissues [10,12].…”

Section: Introductionmentioning

confidence: 99%

Breast Radiation Correlates with Side of Parathyroid Adenoma

Woll¹,

Mazeh²,

Anderson

et al. 2011

World j. surg.

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show abstract

“…This finding indicates that the benefits of OS from post-BCS RT extend beyond just the luminal subtypes and apply to basal-like and HER2-enriched breast cancers. The lack of tumor control in basal-like and HER2-enriched breast cancers did not diminish the OS benefits of post-BCS RT, suggesting that RT has a robust effect on prolonging survival in post-BCS patients [ 5 , 44 , 45 ]. It is a proven fact that post-BCS RT has noticeable positive effects on breast cancer patients, with both breast-cancer-specific survival and OS significantly improved even in elderly patients (age ≥ 70 years) [ 44 ].…”

Section: Discussionmentioning

confidence: 99%

Molecular subtypes of breast cancer predicting clinical benefits of radiotherapy after breast-conserving surgery: a propensity-score-matched cohort study

Hung,

Yang,

Lee

et al. 2023

Breast Cancer Res

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Background Based on the molecular expression of cancer cells, molecular subtypes of breast cancer have been applied to classify patients for predicting clinical outcomes and prognosis. However, further evidence is needed regarding the influence of molecular subtypes on the efficacy of radiotherapy (RT) after breast-conserving surgery (BCS), particularly in a population-based context. Hence, the present study employed a propensity-score-matched cohort design to investigate the potential role of molecular subtypes in stratifying patient outcomes for post-BCS RT and to identify the specific clinical benefits that may emerge. Methods From 2006 to 2019, the present study included 59,502 breast cancer patients who underwent BCS from the Taiwan National Health Insurance Research Database. Propensity scores were utilized to match confounding variables between patients with and without RT within each subtype of breast cancer, namely luminal A, luminal B/HER2-negative, luminal B/HER2-positive, basal-like, and HER2-enriched ones. Several clinical outcomes were assessed, in terms of local recurrence (LR), regional recurrence (RR), distant metastasis (DM), disease-free survival (DFS), and overall survival (OS). Results After post-BCS RT, patients with luminal A and luminal B/HER2-positive breast cancers exhibited a decrease in LR (adjusted hazard ratio [aHR] = 0.18, p < 0.0001; and, 0.24, p = 0.0049, respectively). Furthermore, reduced RR and improved DFS were observed in patients with luminal A (aHR = 0.15, p = 0.0004; and 0.29, p < 0.0001), luminal B/HER2-negative (aHR = 0.06, p = 0.0093; and, 0.46, p = 0.028), and luminal B/HER2-positive (aHR = 0.14, p = 0.01; and, 0.38, p < 0.0001) breast cancers. Notably, OS benefits were found in patients with luminal A (aHR = 0.62, p = 0.002), luminal B/HER2-negative (aHR = 0.30, p < 0.0001), basal-like (aHR = 0.40, p < 0.0001), and HER2-enriched (aHR = 0.50, p = 0.03), but not luminal B/HER2-positive diseases. Remarkably, when considering DM, luminal A patients who received RT demonstrated a lower cumulative incidence of DM than those without RT (p = 0.02). Conclusion In patients with luminal A breast cancer who undergo BCS, RT could decrease the likelihood of tumor metastasis. After RT, the tumor’s hormone receptor status may predict tumor control regarding LR, RR, and DFS. Besides, the HER2 status of luminal breast cancer patients may serve as an additional predictor of OS after post-BCS RT. However, further prospective studies are required to validate these findings.

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“…With the diagnosis and treatment of breast cancer becoming more and more standardized, the mortality of breast cancer patients after breast-conserving surgery also decreased. Radiotherapy after breast-conserving surgery has become the standard treatment for breast cancer patients [ 5 , 6 ]. However, there were still some patients who did not receive radiotherapy after breast-conserving therapy.…”

Section: Introductionmentioning

confidence: 99%

Radiotherapy refusal in breast cancer with breast-conserving surgery

Liu,

Zhu,

Hua

et al. 2023

Radiat Oncol

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Background Although radiotherapy after breast-conserving surgery has been the standard treatment for breast cancer, some people still refuse to undergo radiotherapy. The aim of this study is to identify risk factors for refusal of radiotherapy after breast-conserving surgery. Methods To investigate the trend of refusing radiotherapy after breast-conserving surgery in patients with breast cancer using the Surveillance, Epidemiology, and End Results database. The patients were divided into radiotherapy group and radiotherapy refusal group. Survival results were compared using a multivariate Cox risk model adjusted for clinicopathological variables. Multivariate logistic regression was used to analyze the influencing factors of patients refusing radiotherapy after breast-conserving surgery and a nomogram model was established. Results The study included 87,100 women who underwent breast-conserving surgery for breast cancer between 2010 and 2015. There were 84,948 patients (97.5%) in the radiotherapy group and 2152 patients (2.5%) in the radiotherapy refusal group. The proportion of patients who refused radiotherapy after breast-conserving surgery increased from 2.1% in 2010 to 3.1% in 2015. The Kaplan–Meier survival curve showed that radiotherapy can improve overall survival (p < 0.001) and breast cancer specific survival (p < 0.001) in the patients with breast-conserving surgery. The results of multivariate logistic regression showed that age, income, marital status, race, grade, stage, subtype and chemotherapy were independent factors associated with the refusal of radiotherapy. Conclusions Postoperative radiotherapy can improve the benefits of breast-conserving surgery. Patients with old age, low income, divorce, white race, advanced stage, and no chemotherapy were more likely to refuse radiotherapy.

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Radiation therapy after breast-conserving surgery

Cited by 4 publications

References 118 publications

Breast Radiation Correlates with Side of Parathyroid Adenoma

Breast Radiation Correlates with Side of Parathyroid Adenoma

Molecular subtypes of breast cancer predicting clinical benefits of radiotherapy after breast-conserving surgery: a propensity-score-matched cohort study

Radiotherapy refusal in breast cancer with breast-conserving surgery

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