PURPOSE: To investigate the long-term impact of pathologic characteristics and an extra boost dose of 16 Gy on local relapse, for stage I and II invasive breast cancer patients treated withbreast conserving therapy (BCT). PATIENTS AND METHODS: In the European Organisation for Research and Treatment of Cancer boost versus no boost trial, after whole breast irradiation, patients with microscopically complete excision of invasive tumor, were randomly assigned to receive or not an extra boost dose of 16 Gy. For a subset of 1,616 patients central pathology review was performed. RESULTS: The 10-year cumulative risk of local breast cancer relapse as a first event was not significantly influenced if the margin was scored negative, close or positive for invasive tumor or ductal carcinoma in situ according to central pathology review (log-rank P = .45 and P = .57, respectively). In multivariate analysis, high-grade invasive ductal carcinoma was associated with an increased risk of local relapse (P = .026; hazard ratio [HR], 1.67), as was age younger than 50 years (P < .0001; HR, 2.38). The boost dose of 16 Gy significantly reduced the local relapse rate (P = .0006; HR, 0.47). For patients younger than 50 years old and in patients with high grade invasive ductal carcinoma, the boost dose reduced the local relapse from 19.4% to 11.4% (P = .0046; HR, 0.51) and from 18.9% to 8.6% (P = .01; HR, 0.42), respectively. CONCLUSION:Young age and high-grade invasive ductal cancer were the most important risk factors for local relapse, while margin status had no significant influence. A boost dose of 16 Gy significantly reduced the negative effects of both young age and high-grade invasive cancer.
RCT Entities:
PURPOSE: To investigate the long-term impact of pathologic characteristics and an extra boost dose of 16 Gy on local relapse, for stage I and II invasive breast cancerpatients treated with breast conserving therapy (BCT). PATIENTS AND METHODS: In the European Organisation for Research and Treatment of Cancer boost versus no boost trial, after whole breast irradiation, patients with microscopically complete excision of invasive tumor, were randomly assigned to receive or not an extra boost dose of 16 Gy. For a subset of 1,616 patients central pathology review was performed. RESULTS: The 10-year cumulative risk of local breast cancer relapse as a first event was not significantly influenced if the margin was scored negative, close or positive for invasive tumor or ductal carcinoma in situ according to central pathology review (log-rank P = .45 and P = .57, respectively). In multivariate analysis, high-grade invasive ductal carcinoma was associated with an increased risk of local relapse (P = .026; hazard ratio [HR], 1.67), as was age younger than 50 years (P < .0001; HR, 2.38). The boost dose of 16 Gy significantly reduced the local relapse rate (P = .0006; HR, 0.47). For patients younger than 50 years old and in patients with high grade invasive ductal carcinoma, the boost dose reduced the local relapse from 19.4% to 11.4% (P = .0046; HR, 0.51) and from 18.9% to 8.6% (P = .01; HR, 0.42), respectively. CONCLUSION: Young age and high-grade invasive ductal cancer were the most important risk factors for local relapse, while margin status had no significant influence. A boost dose of 16 Gy significantly reduced the negative effects of both young age and high-grade invasive cancer.
Authors: C M Mansfield; L T Komarnicky; G F Schwartz; A L Rosenberg; L Krishnan; W R Jewell; F E Rosato; M L Moses; M Haghbin; J Taylor Journal: Cancer Date: 1995-05-01 Impact factor: 6.860
Authors: J A Jacobson; D N Danforth; K H Cowan; T d'Angelo; S M Steinberg; L Pierce; M E Lippman; A S Lichter; E Glatstein; P Okunieff Journal: N Engl J Med Date: 1995-04-06 Impact factor: 91.245
Authors: R Heimann; C Powers; H J Halpem; A G Michel; C A Ewing; B Wyman; W Recant; R R Weichselbaum Journal: Cancer Date: 1996-10-15 Impact factor: 6.860
Authors: R Holland; J L Peterse; R R Millis; V Eusebi; D Faverly; M J van de Vijver; B Zafrani Journal: Semin Diagn Pathol Date: 1994-08 Impact factor: 3.464
Authors: U Veronesi; B Salvadori; A Luini; M Greco; R Saccozzi; M del Vecchio; L Mariani; S Zurrida; F Rilke Journal: Eur J Cancer Date: 1995-09 Impact factor: 9.162
Authors: Meena S Moran; Stuart J Schnitt; Armando E Giuliano; Jay R Harris; Seema A Khan; Janet Horton; Suzanne Klimberg; Mariana Chavez-MacGregor; Gary Freedman; Nehmat Houssami; Peggy L Johnson; Monica Morrow Journal: Int J Radiat Oncol Biol Phys Date: 2014-03-01 Impact factor: 7.038