Conservative surgery with and without radiotherapy in elderly patients with early-stage breast cancer: A prospective randomised multicentre trial |
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Authors: | C. Tinterri W. Gatzemeier V. Zanini L. Regolo C. Pedrazzoli E. Rondini C. Amanti G. Gentile M. Taffurelli P. Fenaroli C. Tondini G. Sacchetto P. Sismondi R. Murgo M. Orlandi E. Cianchetti C. Andreoli |
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Affiliation: | 1. Breast Unit, Istituto Clinico Humanitas, via Manzoni 56, 20089 Rozzano, Milano, Italy;2. Division of Surgery and Senology, The Maugeri Foundation, Pavia, Italy;3. Italian School of Senology, Milan, Italy;4. Division of Surgery, General Hospital Alba, Italy;5. Division of Surgery and Senology, General Hospital Bergamo, Italy;6. Division of Senology, General Hospital Ortona, Italy;7. Division of Surgery, Arcispedale Santa Maria Nuova Reggio Emilia, Italy;8. Division of Surgical Science and Medical Technology, University La Sapienza, Roma, Italy;9. Division of Surgery, Casa Sollievo della Sofferenza Hospital, S. Giovanni Rotondo, Italy;10. Division of Surgery, S. Orsola Malpighi Hospital, Bologna, Italy;11. Division of Surgery, S. Maria della Misericordia Hospital, Udine, Italy;12. Division of Gynaecology, Cancer Research Centre Torino, Turin, Italy;13. Division of Gynaecology, General Hospital Cirié, Italy |
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Abstract: | Breast conserving therapy (BCT) including postoperative irradiation of the remaining breast tissue is generally accepted as the best treatment for the majority of patients with early-stage breast cancer. The question is whether there is a necessity for irradiating all patients. Between 2001 and 2005, 749 women aged 55–75 years with infiltrating breast carcinoma were randomly assigned to breast conservative surgery, with or without radiotherapy (RT), to evaluate the incidence of in-breast recurrence (IBR).After 5 years of median follow-up, the cumulative incidence of IBR was 2.5% in the surgery-only arm and 0.7% in the surgery plus RT arm. There are no differences in terms of overall survival and distant disease-free survival. The preliminary evaluation suggests that breast irradiation after conservative surgery can be avoided without exposing these patients to an increased risk of distant-disease recurrence. Prolonged follow-up will further clarify the possible risks and late sequelae potentially induced by breast RT. |
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