Abstract | BACKGROUND: Whether radiotherapy (RT) is beneficial in elderly (⩾ 70 years) patients undergoing conservative surgery for early breast cancer has long been controversial. Recent randomised trials show that most elderly patients do not benefit from RT. We started a prospective non-randomised trial to address this issue in 1987 and now present results for the 627 consecutive pT1/2cN0 patients recruited, and treated by conservative surgery (quadrantectomy) and tamoxifen, and assigned non-randomly to RT or no RT. METHODS: We used multivariate competing risks models to estimate 15-crude cumulative incidence (CCI) of ipsilateral breast tumour recurrence (IBTR), distant metastasis and breast cancer mortality. The models incorporated a propensity score as a measure of probability of receiving RT based on baseline characteristics, to account for the lack of randomisation. RESULTS: For pT1 patients, 15-year CCIs of IBTR, distant metastasis and breast cancer death were indistinguishable in the RT and no RT groups. For pT2 patients, 15-year CCI of IBTR was much higher in those not given RT (14.6% versus 0.8%, p = 0.004), although breast cancer mortality and distant metastasis did not differ significantly between RT and no RT. CONCLUSIONS: Consistent with the findings of recent randomised trials, our long-term data indicate that most elderly, ER-positive patients with pT1 cN0 breast cancer treated by quadrantectomy do not benefit from RT. The 14.6% CCI of IBTR in our pT2 patients is an additional finding not presented in the trials and suggests that RT should be administered to elderly patients with pT2 disease.
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Authors | Gabriele Martelli, Patrizia Boracchi, Eleonora Guzzetti, Giuseppe Marano, Laura Lozza, Roberto Agresti, Cristina Ferraris, Domenico Piromalli, Marco Greco |
Journal | European journal of cancer (Oxford, England : 1990)
(Eur J Cancer)
Vol. 51
Issue 11
Pg. 1358-64
(Jul 2015)
ISSN: 1879-0852 [Electronic] England |
PMID | 26003208
(Publication Type: Clinical Trial, Journal Article)
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Copyright | Copyright © 2015 Elsevier Ltd. All rights reserved. |
Topics |
- Age Factors
- Aged
- Aged, 80 and over
- Breast Neoplasms
(pathology, radiotherapy)
- Female
- Humans
- Multivariate Analysis
- Neoplasm Staging
- Prospective Studies
- Radiotherapy
- Randomized Controlled Trials as Topic
- Treatment Outcome
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