PURPOSE:Locoregional failure after breast-conserving surgery is associated with increased risk of distant disease and death. The magnitude of this risk in patients receivingchemotherapy has not been adequately characterized. PATIENTS AND METHODS: Our study population included 2,669 women randomly assigned onto fiveNational Surgical Adjuvant Breast and Bowel Project node-positive protocols (B-15, B-16, B-18, B-22, and B-25), who were treated with lumpectomy, whole-breast irradiation, and adjuvant systemic therapy. Cumulative incidences of ipsilateral breast tumor recurrence (IBTR) and other locoregional recurrence (oLRR) were calculated. Kaplan-Meier curves were used to estimate distant-disease-free survival (DDFS) and overall survival (OS) after IBTR or oLRR. Cox models were used to model survival using clinical and pathologic factors jointly with IBTR or oLRR as time-varying predictors. RESULTS: Four hundred twenty-four patients (15.9%) experienced locoregional failure; 259 (9.7%) experienced IBTR, and 165 (6.2%) experienced oLRR. The 10-year cumulative incidence of IBTR andoLRR was 8.7% and 6.0%, respectively. Most locoregional failures occurred within 5 years (62.2% for IBTR and 80.6% for oLRR). Age, tumor size, and estrogen receptor status were significantly associated with IBTR. Nodal status and estrogen and progesterone receptor status were significantly associated with oLRR. The 5-year DDFS rates after IBTR and oLRR were 51.4% and 18.8%, respectively. The 5-year OS rates after IBTR and oLRR were 59.9% and 24.1%, respectively. Hazard ratios for mortality associated with IBTR and oLRR were 2.58 (95% CI, 2.11 to 3.15) and 5.85 (95% CI, 4.80 to 7.13), respectively. CONCLUSION:Node-positive breast cancer patients who developed IBTR or oLRR had significantly poorer prognoses than patients who did not experience these events.
RCT Entities:
PURPOSE: Locoregional failure after breast-conserving surgery is associated with increased risk of distant disease and death. The magnitude of this risk in patients receiving chemotherapy has not been adequately characterized. PATIENTS AND METHODS: Our study population included 2,669 women randomly assigned onto five National Surgical Adjuvant Breast and Bowel Project node-positive protocols (B-15, B-16, B-18, B-22, and B-25), who were treated with lumpectomy, whole-breast irradiation, and adjuvant systemic therapy. Cumulative incidences of ipsilateral breast tumor recurrence (IBTR) and other locoregional recurrence (oLRR) were calculated. Kaplan-Meier curves were used to estimate distant-disease-free survival (DDFS) and overall survival (OS) after IBTR or oLRR. Cox models were used to model survival using clinical and pathologic factors jointly with IBTR or oLRR as time-varying predictors. RESULTS: Four hundred twenty-four patients (15.9%) experienced locoregional failure; 259 (9.7%) experienced IBTR, and 165 (6.2%) experienced oLRR. The 10-year cumulative incidence of IBTR and oLRR was 8.7% and 6.0%, respectively. Most locoregional failures occurred within 5 years (62.2% for IBTR and 80.6% for oLRR). Age, tumor size, and estrogen receptor status were significantly associated with IBTR. Nodal status and estrogen and progesterone receptor status were significantly associated with oLRR. The 5-year DDFS rates after IBTR and oLRR were 51.4% and 18.8%, respectively. The 5-year OS rates after IBTR and oLRR were 59.9% and 24.1%, respectively. Hazard ratios for mortality associated with IBTR and oLRR were 2.58 (95% CI, 2.11 to 3.15) and 5.85 (95% CI, 4.80 to 7.13), respectively. CONCLUSION: Node-positive breast cancerpatients who developed IBTR or oLRR had significantly poorer prognoses than patients who did not experience these events.
Authors: Michael J Hassett; Hajime Uno; Angel M Cronin; Nikki M Carroll; Mark C Hornbrook; Paul Fishman; Debra P Ritzwoller Journal: Cancer Epidemiol Date: 2017-07-12 Impact factor: 2.984
Authors: Stefan Aebi; Shari Gelber; Stewart J Anderson; István Láng; André Robidoux; Miguel Martín; Johan W R Nortier; Alexander H G Paterson; Mothaffar F Rimawi; José Manuel Baena Cañada; Beat Thürlimann; Elizabeth Murray; Eleftherios P Mamounas; Charles E Geyer; Karen N Price; Alan S Coates; Richard D Gelber; Priya Rastogi; Norman Wolmark; Irene L Wapnir Journal: Lancet Oncol Date: 2014-01-16 Impact factor: 41.316
Authors: Irene L Wapnir; Shari Gelber; Stewart J Anderson; Eleftherios P Mamounas; André Robidoux; Miguel Martín; Johan W R Nortier; Charles E Geyer; Alexander H G Paterson; István Láng; Karen N Price; Alan S Coates; Richard D Gelber; Priya Rastogi; Meredith M Regan; Norman Wolmark; Stefan Aebi Journal: Ann Surg Oncol Date: 2016-09-23 Impact factor: 5.344
Authors: Soo Yeon Baek; Jisun Kim; Il Yong Chung; Beom Seok Ko; Hee Jeong Kim; Jong Won Lee; Byung Ho Son; Sei-Hyun Ahn; Sae Byul Lee Journal: Breast Cancer Res Treat Date: 2020-09-15 Impact factor: 4.872