Role of boost radiotherapy for local control of pure ductal carcinoma in situ after breast-conserving surgery: a multicenter, retrospective study of 622 patients

Cambra, M.J.; Moreno, F.; Sanz, X.; Anglada, L.; Mollà, Meritxell; Reyes, V.; Arenas, Meritxell; Pedro, A.; Ballester, R.; García, Víctor Manuel Pérez; Casals, Joan; Cusidó, Maite; Jiménez, Carlos López; Escribà, Josep M.; Maciá, M.; Solé, Josep María Macias i; Arcusa, Àngels; Seguí, M. Á.; González, Sónia; Farrús, Blanca; Biete, Albert

doi:10.1007/s12094-019-02168-x

Cited by 2 publications

(2 citation statements)

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“…Результаты исследований сыграли решающую роль в изменении парадигмы хирургического лечения РМЖ [4][5][6]. За последние годы опубликовано несколько ретроспективных исследований, в которых отмечено преимущество ОСО перед РМЭ по общей выживаемости [7][8][9]. В других исследованиях на группе молодых женщин с тройным негативным типом рака продемонстрировано отсутствие статистически значимой разницы в безрецидивной и общей выживаемости при выполнении ОСО и РМЭ [10,11].…”

Section: список сокращенийunclassified

Local-free recurrence survival after breast-conserving surgery and the breast cancer complex treatment

Зикиряходжаев

Ермощенкова

Bosieva

et al. 2021

jour

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Aim. To determine the frequency of local recurrence of breast cancer (BC) after performing breast-conserving surgery (BCS) during and after complex treatment, to study the risk factors for local recurrence and survival.Materials and methods. A retrospective cohort study of 675 patients with breast cancer who underwent BCS followed by remote radiotherapy was conducted. The frequency of local relapse and risk factors were studied, 3- and 5-year local-free survival. The odds ratios (OR) and 95% confidence intervals (CI) were calculated, and the Kaplan–Meyer curves were constructed.Results. Radical breast resections (RBR) were performed in 46.7% of patients, and oncoplastic breast resections (OBS) in 53.3% of patients. The most common histological type in both groups was invasive cancer with no signs of specificity: 76.9% and 84.1% – in the OBS and RBR groups, respectively. The incidence of cancer in situ was higher in the OBS group: 14.7% vs. 3.3% in the RBR group (p < 0.001), metastases in regional lymph nodes were more frequent in the RBR group: 34.3% against 20.3% in OBS (p < 0.001). According to the immunohistochemical type and degree of differentiation, the groups did not differ. For 3 years, the relapse-free survival rate was 99.7% in both groups, and for 5 years – 99.2% in the OBS group. and 99.7% in the RBR group, 6 years – 98.3% and 98.7%, respectively; no significant differences were found between the groups. There were no statistically significant differences in the frequency of relapses depending on the width of the resection edges from <1 to ≥10 mm. The risk of relapse was increased with a preserved menstrual status (OR 20.05; 95% CI 2.52–159.33), Her2/neu–positive (OR 5.11; 95% CI 1.04–25.09) and triple-negative types (OR 4.02; 95% CI 1.02–15.95), the degree of differentiation of G3 (OR 5.58; 95% CI 1.59–19.64).Conclusion. BCS is characterized by oncological safety; the rate of local relapse within 6 years is 1.5%. Risk factors for relapse include active menstrual status, highly aggressive immunohistochemical types of breast cancer, and low degree of differentiation.

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Section: список сокращенийunclassified

Local-free recurrence survival after breast-conserving surgery and the breast cancer complex treatment

Зикиряходжаев

Ермощенкова

Bosieva

et al. 2021

jour

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“…The role of a boost dose to the lumpectomy cavity for DCIS after BCS is debated. A meta-analysis of observational studies showed a boost to reduce the risk of LRs in the case of positive margins, but a subsequent multicenter retrospective trial failed to confirm this finding [ 11 , 17 , 18 ]. In the BIG 03-07/TROG 07-01, a risk reduction of more than half was observed at 5 years, for patients receiving a boost dose to the tumor bed.…”

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confidence: 99%

Hypofractionation and Concomitant Boost in Ductal Carcinoma In Situ (DCIS): Analysis of a Prospective Case Series with Long-Term Follow-Up

Cante

Paolini

Piva

et al. 2022

Life

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We previously reported on a cohort of breast cancer patients affected with ductal carcinoma in situ (DCIS) that were treated with breast conservative surgery and hypofractionated whole-breast radiotherapy with a concomitant boost to the lumpectomy cavity. We now report on the long-term results of the oncological and toxicity outcomes, at a median follow-up of 11.2 years. We also include an analysis of the predictive factors for local recurrence (LR). Eighty-two patients with long-term observation were considered for this report. All received hypofractionated post-operative radiotherapy with a concomitant boost (45 Gy/20 fractions to the whole breast and 50 Gy/20 fractions to the lumpectomy cavity). We report on LC rates at 5 and 10 years, overall survival (OS), and breast-cancer-specific survival (BCSS), employing the Kaplan–Meier method. Cox proportional regression analysis was used to determine the role of selected clinical parameters on the risk of local recurrence, by the univariate and multivariate models. After a median follow-up of 11.2 years (range 5–15 years), 9 pts (11%) developed LR. The LR rates at 5 years and 10 years were 2.4% and 8.2%, respectively. The 5- and 10-year overall survival rates were 98.8% and 91.6%, respectively. The 5- and 10-year breast-cancer-specific survival rates were 100.0% and 99.0%. Late skin and subcutaneous toxicities were generally mild, and cosmetic results were good–excellent for most patients. For the univariate regression analysis, ER positive status (HR; 95% CI, p = 0.021), PgR positive status (HR; 95% CI, p = 0.012), and the aggregate data of positive hormonal status (HR; 95% CI, p = 0.021) were inversely correlated to LR risk. Conversely, a high tumor grade (G3) was directly correlated with the risk of LR (HR; 95% CI, p = 0.048). For the multivariate regression analysis, a high tumor grade (G3) confirmed its negative impact on LR (HR 0.40; 95% CI 0.19–0.75, p = 0.047). Our long-term data demonstrate hypofractionated whole-breast radiotherapy with a concomitant boost to be feasable, effective, and tolerable. Our experience suggests positive hormonal status to be protective with respect to LR risk. A high tumor grade is a risk factor for LR.

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Role of boost radiotherapy for local control of pure ductal carcinoma in situ after breast-conserving surgery: a multicenter, retrospective study of 622 patients

Cited by 2 publications

References 32 publications

Local-free recurrence survival after breast-conserving surgery and the breast cancer complex treatment

Local-free recurrence survival after breast-conserving surgery and the breast cancer complex treatment

Hypofractionation and Concomitant Boost in Ductal Carcinoma In Situ (DCIS): Analysis of a Prospective Case Series with Long-Term Follow-Up

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