K Guidolin1, M Lock2,3, K Vogt2,3, J A McClure4, J Winick-Ng4, C Vinden2,3,4, M Brackstone2,3. 1. Department of Surgery, University of Toronto, Toronto. 2. Schulich School of Medicine and Dentistry, Western University, London. 3. London Health Sciences Centre, London. 4. ices, London, ON.
Abstract
Background: Breast-conserving surgery (bcs) and radiation therapy (rt) are the standard of care for early breast cancer; studies have demonstrated that adjuvant rt confers a protective effect with respect to recurrence, although no randomized trials have shown a survival benefit. Methods: This retrospective cohort study used Ontario data linked through ices to examine patients treated for breast cancer between 1 April 2007 and 31 March 2014. The primary outcome was death or recurrence. Outcomes were compared between patients who did and did not receive rt. Results: The total cohort size was 26,279. The hazard ratios (hrs) for various outcomes were significantly higher for patients who did not receive rt than for patients who did: recurrence or death combined [hr: 2.49; 95% confidence interval (ci): 2.25 to 2.75], recurrence (hr: 2.33; 95% ci: 1.91 to 2.84), and death (hr: 2.28; 95% ci: 2.03 to 2.56). The hr for death was 1.81 (95% ci: 1.65 to 1.99) for patients having stage ii cancer compared with those having stage i disease. The hr for death was 1.97 (95% ci: 1.74 to 2.22) for patients having high comorbidity compared with those having little comorbidity. Conclusions: Adjuvant rt carries a protective effect with respect to recurrence and survival in patients with early-stage breast cancer. That survival benefit has not been appreciated in previous randomized trials and underscores the importance of rt as a component of breast cancer treatment. 2019 Multimed Inc.
Background: Breast-conserving surgery (bcs) and radiation therapy (rt) are the standard of care for early breast cancer; studies have demonstrated that adjuvant rt confers a protective effect with respect to recurrence, although no randomized trials have shown a survival benefit. Methods: This retrospective cohort study used Ontario data linked through ices to examine patients treated for breast cancer between 1 April 2007 and 31 March 2014. The primary outcome was death or recurrence. Outcomes were compared between patients who did and did not receive rt. Results: The total cohort size was 26,279. The hazard ratios (hrs) for various outcomes were significantly higher for patients who did not receive rt than for patients who did: recurrence or death combined [hr: 2.49; 95% confidence interval (ci): 2.25 to 2.75], recurrence (hr: 2.33; 95% ci: 1.91 to 2.84), and death (hr: 2.28; 95% ci: 2.03 to 2.56). The hr for death was 1.81 (95% ci: 1.65 to 1.99) for patients having stage ii cancer compared with those having stage i disease. The hr for death was 1.97 (95% ci: 1.74 to 2.22) for patients having high comorbidity compared with those having little comorbidity. Conclusions: Adjuvant rt carries a protective effect with respect to recurrence and survival in patients with early-stage breast cancer. That survival benefit has not been appreciated in previous randomized trials and underscores the importance of rt as a component of breast cancer treatment. 2019 Multimed Inc.
Entities:
Keywords:
Breast cancer; breast-conserving therapy; death; radiation therapy; recurrence
Authors: Douglas S Lee; Audra Stitt; Xuesong Wang; Jeffery S Yu; Yana Gurevich; Kori J Kingsbury; Peter C Austin; Jack V Tu Journal: Med Care Date: 2013-04 Impact factor: 2.983
Authors: Deirdre A Hill; Sarah Friend; Lesley Lomo; Charles Wiggins; Marc Barry; Eric Prossnitz; Melanie Royce Journal: Breast Cancer Res Treat Date: 2018-03-22 Impact factor: 4.872
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: Anthony W Fyles; David R McCready; Lee A Manchul; Maureen E Trudeau; Patricia Merante; Melania Pintilie; Lorna M Weir; Ivo A Olivotto Journal: N Engl J Med Date: 2004-09-02 Impact factor: 91.245
Authors: Juras Kišonas; Jonas Venius; Olga Sevriukova; Mindaugas Grybauskas; Daiva Dabkevičienė; Arvydas Burneckis; Ričardas Rotomskis Journal: Life (Basel) Date: 2021-12-23