BACKGROUND AND PURPOSE: Overviews of randomized trials have shown a small survival advantage with post-surgery radiation in early breast cancer. The present study attempts to extend this observation through a systematic analysis of population data. MATERIALS AND METHODS: This retrospective cohort study used the Surveillance, Epidemiology, and End Results (SEER) data on 83,776 women with breast cancer diagnosed between 1988 and 1997, stage T1-T2, node negative or node positive. The analysis was performed using the proportional hazard models. RESULTS: Radiation was associated with a reduced mortality after breast-conserving surgery in node negative patients (hazard ratio 0.757; 95% confidence interval 0.709-0.809; using total mastectomy without radiation as reference) and in node positive patients (hazard ratio 0.777; 0.717-0.842), and after total mastectomy in node positive patients (hazard ratio 0.885; 0.815-0.961). Radiation was associated with an increased hazard ratio of 1.271 (1.080-1.496) after total mastectomy in node negative patients. Without radiation, breast-conserving surgery in node negative patients was associated with an increased hazard ratio (1.167; 1.036-1.314); a similar increase was not observed in node positive patients (hazard ratio 1.011; 0.884-1.155). In all cases, the best survival rates were found with combined breast-conserving surgery and radiation. CONCLUSION: The available data indicate that post-surgery radiation provides a survival advantage irrespective of the type of surgery in node positive patients. Likewise, survival advantage was observed with post-surgery radiation and breast-conserving procedure in node negative patients.
BACKGROUND AND PURPOSE: Overviews of randomized trials have shown a small survival advantage with post-surgery radiation in early breast cancer. The present study attempts to extend this observation through a systematic analysis of population data. MATERIALS AND METHODS: This retrospective cohort study used the Surveillance, Epidemiology, and End Results (SEER) data on 83,776 women with breast cancer diagnosed between 1988 and 1997, stage T1-T2, node negative or node positive. The analysis was performed using the proportional hazard models. RESULTS: Radiation was associated with a reduced mortality after breast-conserving surgery in node negative patients (hazard ratio 0.757; 95% confidence interval 0.709-0.809; using total mastectomy without radiation as reference) and in node positive patients (hazard ratio 0.777; 0.717-0.842), and after total mastectomy in node positive patients (hazard ratio 0.885; 0.815-0.961). Radiation was associated with an increased hazard ratio of 1.271 (1.080-1.496) after total mastectomy in node negative patients. Without radiation, breast-conserving surgery in node negative patients was associated with an increased hazard ratio (1.167; 1.036-1.314); a similar increase was not observed in node positive patients (hazard ratio 1.011; 0.884-1.155). In all cases, the best survival rates were found with combined breast-conserving surgery and radiation. CONCLUSION: The available data indicate that post-surgery radiation provides a survival advantage irrespective of the type of surgery in node positive patients. Likewise, survival advantage was observed with post-surgery radiation and breast-conserving procedure in node negative patients.
Authors: Claire Verschraegen; Vincent Vinh-Hung; Gábor Cserni; Richard Gordon; Melanie E Royce; Georges Vlastos; Patricia Tai; Guy Storme Journal: Ann Surg Date: 2005-02 Impact factor: 12.969
Authors: Gabriel De la Cruz Ku; Manish Karamchandani; Diego Chambergo-Michilot; Alexis R Narvaez-Rojas; Michael Jonczyk; Fortunato S Príncipe-Meneses; David Posawatz; Salvatore Nardello; Abhishek Chatterjee Journal: Ann Surg Oncol Date: 2022-07-25 Impact factor: 4.339
Authors: Patricia Tai; Gábor Cserni; Jan Van De Steene; Georges Vlastos; Mia Voordeckers; Melanie Royce; Sang-Joon Lee; Vincent Vinh-Hung; Guy Storme Journal: BMC Cancer Date: 2005-10-08 Impact factor: 4.430
Authors: Vincent Vinh-Hung; Claire Verschraegen; Donald I Promish; Gábor Cserni; Jan Van de Steene; Patricia Tai; Georges Vlastos; Mia Voordeckers; Guy Storme; Melanie Royce Journal: Breast Cancer Res Date: 2004-10-06 Impact factor: 6.466