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Medline ® Abstract for Reference 51

of 'Adjuvant radiation therapy for women with newly diagnosed, non-metastatic breast cancer'

51
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Lumpectomy plus tamoxifen with or without irradiation in women age 70 years or older with early breast cancer: long-term follow-up of CALGB 9343.
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Hughes KS, Schnaper LA, Bellon JR, Cirrincione CT, Berry DA, McCormick B, Muss HB, Smith BL, Hudis CA, Winer EP, Wood WC
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J Clin Oncol. 2013;31(19):2382. Epub 2013 May 20.
 
PURPOSE: To determine whether there is a benefit to adjuvant radiation therapy after breast-conserving surgery and tamoxifen in women age≥70 years with early-stage breast cancer.
PATIENTS AND METHODS: Between July 1994 and February 1999, 636 women (age≥70 years) who had clinical stage I (T1N0M0 according to TNM classification) estrogen receptor (ER) -positive breast carcinoma treated by lumpectomy were randomly assigned to receive tamoxifen plus radiation therapy (TamRT; 317 women) or tamoxifen alone (Tam; 319 women). Primary end points were time to local or regional recurrence, frequency of mastectomy, breast cancer-specific survival, time to distant metastasis, and overall survival (OS).
RESULTS: Median follow-up for treated patients is now 12.6 years. At 10 years, 98% of patients receiving TamRT (95% CI, 96% to 99%) compared with 90% of those receiving Tam (95% CI, 85% to 93%) were free from local and regional recurrences. There were no significant differences in time to mastectomy, time to distant metastasis, breast cancer-specific survival, or OS between the two groups. Ten-year OS was 67% (95% CI, 62% to 72%) and 66% (95% CI, 61% to 71%) in the TamRT and Tam groups, respectively.
CONCLUSION: With long-term follow-up, the previously observed small improvement in locoregional recurrence with the addition of radiation therapy remains. However, this does not translate into an advantage in OS, distant disease-free survival, or breast preservation. Depending on the value placed on local recurrence, Tam remains a reasonable option for women age≥70 years with ER-positive early-stage breast cancer.
AD
Harvard Medical School, Boston, MA, USA. kshughes@partners.org
PMID