The effect of timing of radiotherapy after breast-conserving surgery in patients with positive or close resection margins, young age, and node-negative disease, with long term follow-up

Vujovic, Olga; Cherian, Anil; Yu, Edward; Dar, A. Rashid; Stitt, Larry; Perera, Francisco

doi:10.1016/j.ijrobp.2006.05.051

Cited by 38 publications

(27 citation statements)

References 13 publications

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“…Vujovic et al reported that delay in the start of breast irradiation of up to 16 weeks from definitive surgery does not increase the risk of recurrence in node-negative (N0) breast cancer patients. The ''unfavorable'' aspect of the delay is apparently associated with high recurrence rates in patients with positive surgical margins [20,21]. In our present study, less than 10% of patients had a waiting period of greater than 8 weeks, which is unlikely to be found statistically as a risk factor for recurrence within the breast.…”

Section: Radiotherapycontrasting

confidence: 50%

The treatment outcome of patients undergoing breast-conserving therapy: the clinical role of postoperative radiotherapy

Oouchi

Sakata

Masuoka³

et al. 2008

Breast Cancer

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Section: Radiotherapycontrasting

confidence: 50%

The treatment outcome of patients undergoing breast-conserving therapy: the clinical role of postoperative radiotherapy

Oouchi

Sakata

Masuoka³

et al. 2008

Breast Cancer

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“…In addition, we lacked information on margin status; when margins are positive, younger women with RT delay are known to have higher recurrence rates. 22 There was no reason to suspect, however, that women with involved margins in our sample would be more likely to delay, leading to the lower DFS we observed in women who delay.…”

Section: Discussionmentioning

confidence: 75%

Correlates and effect of suboptimal radiotherapy in women with ductal carcinoma in situ or early invasive breast cancer

Gold

Hương²,

Dick

2008

Cancer

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BACKGROUND.The study aimed to identify factors associated with less‐than‐optimal radiotherapy (RT) and its impact on disease‐free survival in women aged 66+ years diagnosed with stage I breast cancer or ductal carcinoma in situ (DCIS).METHODS.The subjects were women diagnosed from 1991 to 1999 in the linked Surveillance, Epidemiology, and End Results (SEER)‐Medicare database who underwent breast‐conserving surgery and RT within 12 months postdiagnosis. The authors conducted descriptive and multivariate survival analyses, and considered age, race, poverty, marital status, comorbidity indices, rural/urban, radiation oncologist density, comedo necrosis histology (DCIS only), chemotherapy receipt (stage I only), and RT completion (3+ weeks of treatment) and delay (8+ weeks postsurgery without chemotherapy; 4+ weeks postchemotherapy).RESULTS.Of 7791 subjects, 16% experienced RT delay, and 3% had incomplete RT. Subjects with stage I disease who were more likely to delay RT were of black race (odds ratio [OR], 1.56; 95% confidence interval [CI], 1.17‐2.08), whereas women in areas of high radiation oncologist density were less likely to delay (OR, 0.73; 95% CI, 0.66‐0.81). Those living in high poverty areas were less likely to complete RT (P < .03), as were those undergoing chemotherapy (OR, 1.82; 95% CI, 1.15‐2.88). Stage I breast cancer patients with delayed RT were more likely to experience a subsequent breast event (OR, 1.14; 95% CI, 1.00‐1.30), and those with incomplete RT had a higher rate of overall mortality (OR, 1.32; 95% CI, 1.06‐1.63). Factors associated with lower subsequent breast events included older age, lower poverty, and being married. RT delays of 12+ weeks (or 8+ weeks postchemotherapy) had a strongly negative impact on subsequent events (OR, 3.94; 95% CI, 2.51‐6.17 for DCIS; OR, 2.77; 95% CI, 1.84‐2.59 for stage I).CONCLUSIONS.RT should be facilitated to ensure completion and timeliness, especially for early invasive breast cancer patients. Cancer 2008. © 2008 American Cancer Society.

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“…Whether or not detrimental effects of adjuvant radiation therapy are to be anticipated, is still a matter of debate [2,28]. However, the start of adjuvant radiation therapy is never urgent; delays of radiation therapy of up to 3-4 months result in similar outcomes as earlier initiation [29][30][31].…”

Section: Radiation Therapymentioning

confidence: 99%

New Therapeutic Options for Breast Cancer during Pregnancy

Loibl¹

2008

Breast Care

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National and international guidelines for pregnant breast cancer patients recommend to treat pregnant patients as closely as possible to the standards for non-pregnant patients. Therefore, new treatment options like sentinel lymph node biopsy or taxane-based chemotherapy have to be carefully checked for their possible implementation even for pregnant patients. These patients need to be treated in a breast cancer center where a multidisciplinary team is ready to support the patient and her family and to serve her with the best up-to-date treatment for mother and child.

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The effect of timing of radiotherapy after breast-conserving surgery in patients with positive or close resection margins, young age, and node-negative disease, with long term follow-up

Cited by 38 publications

References 13 publications

The treatment outcome of patients undergoing breast-conserving therapy: the clinical role of postoperative radiotherapy

The treatment outcome of patients undergoing breast-conserving therapy: the clinical role of postoperative radiotherapy

Correlates and effect of suboptimal radiotherapy in women with ductal carcinoma in situ or early invasive breast cancer

New Therapeutic Options for Breast Cancer during Pregnancy

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