Sector Resection With or Without Postoperative Radiotherapy for Stage I Breast Cancer: Five-Year Results of a Randomized Trial

Liljegren, Göran; Holmberg, Lars; Adami, H.-O.; Westman, Gunnar; Graffman, S.; Bergh, Jonas

doi:10.1093/jnci/86.9.717

Cited by 321 publications

(107 citation statements)

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“…Small tumour size, low grade and old age have been proposed as selection criteria for patients who might not benefit from radiotherapy (Clark et al, 1992;Veronesi et al, 1993;Liljegren et al, 1994). However, in a highly selected group of 87 patients treated with breast-conserving surgery without radiotherapy, the rate of local recurrence rose to 16% when the median follow-up time was 56 months, therefore this prospective clinical trial was closed .…”

Section: Discussionmentioning

confidence: 99%

“…There is a need to investigate optional or additional treatment modalities such as more effective systemic therapies for women with a risk of local recurrence after limited surgery and irradiation (Gelber and Goldhirsch, 1994). Attempts have also been made to find a subgroup of low-risk patients who do not need radiotherapy (Clark et al, 1992;Veronesi et al, 1993;Liljegren et al, 1994).…”

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confidence: 99%

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Tenascin-C expression in invasion border of early breast cancer: a predictor of local and distant recurrence

Jahkola

Toivonen²,

Virtanen³

et al. 1998

Br J Cancer

101

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Summary We have recently demonstrated an association between distant metastasis and the expression of the extracellular matrix glycoprotein tenascin-C (Tn-C) in the invasion border of small axillary node-negative breast carcinomas. Our purpose was to assess the relationship between the expression of Tn-C in the tumour invasion border and several histopathological and biological variables and to compare their usefulness in predicting local and distant disease recurrences. The original patient group consisted of 143 women with axillary node-negative breast cancer (one bilateral) treated with breast-conserving surgery and post-operative radiotherapy, and followed for a median of 8 years. Because of the small number of recurrences an additional group of 15 similarly treated women with recurrent breast cancer was also studied. The size of the tumour, its histology, including a possible intraductal component, and grade were re-evaluated. The expression of erbB-2, p53, Ki-67 and Tn-C was evaluated by immunohistochemistry. Ploidy and S-phase fraction (SPF) were assessed by flow cytometry. The only statistically significant prognostic factor for local recurrence was Tn-C expression in the invasion border. For metastasis Ki-67 positivity, tumour size and Tn-C expression in the invasion border were statistically significant, but Ki-67 positivity was the only independent prognostic factor. Tn-C expression in the invasion border was associated with a higher proliferation rate measured by Ki-67 and SPF, which is consistent with the suggested growth-promoting activity of Tn-C. Tn-C may be a useful marker in selecting patients for adjuvant therapies to reduce the rate of both local and distant cancer recurrences.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Tenascin-C expression in invasion border of early breast cancer: a predictor of local and distant recurrence

Jahkola

Toivonen²,

Virtanen³

et al. 1998

Br J Cancer

101

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“…Although mastectomy and BCS (with follow-up radiation therapy) have equivalent outcomes (breast carcinoma recurrence rates, survival rates) for treating early-stage breast carcinoma, BCS without follow-up radiation therapy has an increased risk of breast carcinoma recurrence [5][6][7][8][9][10][11] and mortality. 12 Results of studies on racial differences in the use of BCS are inconsistent.…”

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confidence: 99%

Racial differences in treatment and survival from early‐stage breast carcinoma

Joslyn

2002

Cancer

109

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BACKGROUNDAfrican‐American women have a significantly worse prognosis from breast carcinoma compared with white women, even when the stage at diagnosis is equivalent. The purpose of this study was to analyze racial differences in the treatment (use of breast‐conserving surgery and radiation therapy) of women with early‐stage breast carcinoma and the resulting effects on survival rates.METHODSSubjects included 10,073 African‐American and 123,127 white women diagnosed with Stage I, IIA, or IIB breast carcinoma in the National Cancer Institute's Surveillance, Epidemiology, and End Results program between 1988 and 1998. Comparisons were made by race with treatment, age, hormone receptor status, and stage at the time of diagnosis. Survival analyses were conducted to compare risk of death for African‐American and white women while controlling for age, stage, and hormone receptor status.RESULTSAmong women diagnosed with early‐stage breast carcinoma who receive breast‐conserving surgery, African‐American women were significantly less likely to receive follow‐up radiation therapy in every 10‐year age group except in the older than 85 age group. Whether treatment was equivalent or suboptimal, survival for African‐American women with early‐stage breast carcinoma was significantly worse. However, when treatment was equivalent, the effects of racial differences on survival were significantly less compared with survival associated with suboptimal treatment.CONCLUSIONSSignificant racial differences exist in the treatment of women with early‐stage breast carcinoma. Public health efforts to eliminate suboptimal treatment would reduce, but not eliminate, racial disparity in survival. Cancer 2002;95:1759–66. © 2002 American Cancer Society.DOI 10.1002/cncr.10827

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“…9 -11 Several studies have shown that the majority of in-breast disease recurrences occur in the immediate vicinity of the lumpectomy cavity. [12][13][14][15] Disease recurrences elsewhere in the breast are found with extended follow-up in only 1-3% of patients. [12][13][14] These data suggest that the impact of whole breast RT on reducing the in-breast recurrence rate is limited to the site of initial involvement.…”

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Potential applicability of balloon catheter–based accelerated partial breast irradiation after conservative surgery for breast carcinoma

Pawlik

M.S.

Strom

et al. 2004

Cancer

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The evaporation behavior of urea‐water‐solution (UWS) droplet was investigated for application to urea‐selective catalytic reduction (SCR) systems. A number of experiments were performed with single UWS droplet suspended on the tip of a fine quartz fiber. To cover the temperature range of real‐world diesel exhausts, droplet ambient temperature was regulated from 373 to 873 K using an electrical furnace. As a result of this study, UWS droplet revealed different evaporation characteristics depending on its ambient temperature. At high temperatures, it showed quite complicated behaviors such as bubble formation, distortion, and partial rupture after a linear D2‐law period. However, as temperature decreases, these phenomena became weak and finally disappeared. Also, droplet diminishment coefficients were extracted from transient evaporation histories for various ambient temperatures, which yields a quantitative evaluation on evaporation characteristics of UWS droplet as well as provides valuable empirical data required for modeling or simulation works on urea‐SCR systems. © 2009 American Institute of Chemical Engineers AIChE J, 2009

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Sector Resection With or Without Postoperative Radiotherapy for Stage I Breast Cancer: Five-Year Results of a Randomized Trial

Cited by 321 publications

References 0 publications

Tenascin-C expression in invasion border of early breast cancer: a predictor of local and distant recurrence

Tenascin-C expression in invasion border of early breast cancer: a predictor of local and distant recurrence

Racial differences in treatment and survival from early‐stage breast carcinoma

Potential applicability of balloon catheter–based accelerated partial breast irradiation after conservative surgery for breast carcinoma

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