Nisha Wu1,2, Qiao Tan3, Xiaohan Su3, Yewei Yuan1, Lingmi Hou4,5, Junyan Li6. 1. Department of Breast Surgery, Sichuan Provincial Maternity and Child Health Care Hospital, No. 290 West Second Street, Shayan Road, Chengdu, 610031, Sichuan, China. 2. Department of Clinical Laboratory, The Fifth Affiliated Hospital, Southern Medical University, Guangzhou, Guangdong, China. 3. Department of Biological Targeting Laboratory of Breast Cancer, Academician (Expert) Workstation, Breast and Thyroid Surgery, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China. 4. Department of Biological Targeting Laboratory of Breast Cancer, Academician (Expert) Workstation, Breast and Thyroid Surgery, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China. houlingmi@163.com. 5. Department of General Surgery, Yingshan Hospital, Southwest Hospital of Sichuan University, 1# Maoyuan Road South, Shunqing District, Nanchong, 637000, Sichuan, China. houlingmi@163.com. 6. Department of Breast Surgery, Sichuan Provincial Maternity and Child Health Care Hospital, No. 290 West Second Street, Shayan Road, Chengdu, 610031, Sichuan, China. lijunyan4990@126.com.
Abstract
INTRODUCTION: The purpose was to evaluate the effect of adjuvant radiation therapy on the survival prognosis of older women with early-stage breast cancer under different surgical treatments. METHODS: We collected patients from the Surveillance, Epidemiology and End Results (SEER) database. Elderly female patients (≥ 70 years) with stage I-IIB diagnosed with invasive carcinoma in 1988-2017 were included. After propensity score matching (PSM), the prognosis of patients who underwent breast-conserving surgery or mastectomy was calculated separately. The effects of radiotherapy on the survival of three special population groups (breast-conserving surgery + T1N0M0 + ER positive, mastectomy + T3N0M0 and mastectomy + T1-2N1M0) were analyzed selectively. RESULTS: Of 106,553 older women with early-stage breast cancer were identified. 48,630 patients had received radiotherapy, while 57,923 patients had not. After PSM, older women undergoing breast-conserving surgery benefited significantly from radiotherapy (both OS and BCSS p < 0.001), for patients with T1N0M0 and ER-positive breast cancer (both OS and BCSS p < 0.001). In the subgroup of T1-2N1M0 breast cancer treated by mastectomy, patients undergoing radiotherapy had a worse survival as well (OS p < 0.001; BCSS p = 0.0907). While in the subgroup of T3N0M0 breast cancer treated by mastectomy, survival analyses showed no statistical differences between patients receiving radiation or not (OS p = 0.1778, BCSS p = 0.6957). CONCLUSIONS: This study indicated the clinical effects of radiation on older women who received different surgical treatments. Our study suggested that radiotherapy should be omitted in older women undergoing mastectomy + T3N0M0 or T1-2N1M0 and radiotherapy could be considered in women with T1N0M0 + ER-positive undergoing breast-conserving surgery.
INTRODUCTION: The purpose was to evaluate the effect of adjuvant radiation therapy on the survival prognosis of older women with early-stage breast cancer under different surgical treatments. METHODS: We collected patients from the Surveillance, Epidemiology and End Results (SEER) database. Elderly female patients (≥ 70 years) with stage I-IIB diagnosed with invasive carcinoma in 1988-2017 were included. After propensity score matching (PSM), the prognosis of patients who underwent breast-conserving surgery or mastectomy was calculated separately. The effects of radiotherapy on the survival of three special population groups (breast-conserving surgery + T1N0M0 + ER positive, mastectomy + T3N0M0 and mastectomy + T1-2N1M0) were analyzed selectively. RESULTS: Of 106,553 older women with early-stage breast cancer were identified. 48,630 patients had received radiotherapy, while 57,923 patients had not. After PSM, older women undergoing breast-conserving surgery benefited significantly from radiotherapy (both OS and BCSS p < 0.001), for patients with T1N0M0 and ER-positive breast cancer (both OS and BCSS p < 0.001). In the subgroup of T1-2N1M0 breast cancer treated by mastectomy, patients undergoing radiotherapy had a worse survival as well (OS p < 0.001; BCSS p = 0.0907). While in the subgroup of T3N0M0 breast cancer treated by mastectomy, survival analyses showed no statistical differences between patients receiving radiation or not (OS p = 0.1778, BCSS p = 0.6957). CONCLUSIONS: This study indicated the clinical effects of radiation on older women who received different surgical treatments. Our study suggested that radiotherapy should be omitted in older women undergoing mastectomy + T3N0M0 or T1-2N1M0 and radiotherapy could be considered in women with T1N0M0 + ER-positive undergoing breast-conserving surgery.
Authors: Dawn L Hershman; Lawrence H Kushi; Theresa Shao; Donna Buono; Aaron Kershenbaum; Wei-Yann Tsai; Louis Fehrenbacher; Scarlett Lin Gomez; Sunita Miles; Alfred I Neugut Journal: J Clin Oncol Date: 2010-06-28 Impact factor: 44.544
Authors: Kevin S Hughes; Lauren A Schnaper; Donald Berry; Constance Cirrincione; Beryl McCormick; Brenda Shank; Judith Wheeler; Lorraine A Champion; Thomas J Smith; Barbara L Smith; Charles Shapiro; Hyman B Muss; Eric Winer; Clifford Hudis; William Wood; David Sugarbaker; I Craig Henderson; Larry Norton Journal: N Engl J Med Date: 2004-09-02 Impact factor: 91.245
Authors: Philip M Poortmans; Caroline Weltens; Catherine Fortpied; Carine Kirkove; Karine Peignaux-Casasnovas; Volker Budach; Femke van der Leij; Ernest Vonk; Nicola Weidner; Sofia Rivera; Geertjan van Tienhoven; Alain Fourquet; Georges Noel; Mariacarla Valli; Matthias Guckenberger; Eveline Koiter; Severine Racadot; Roxolyana Abdah-Bortnyak; Erik F Van Limbergen; Antoine Engelen; Peter De Brouwer; Henk Struikmans; Harry Bartelink Journal: Lancet Oncol Date: 2020-11-02 Impact factor: 41.316
Authors: Tyler R Chesney; Natalie Coburn; Alyson L Mahar; Laura E Davis; Victoria Zuk; Haoyu Zhao; Amy T Hsu; Frances Wright; Barbara Haas; Julie Hallet Journal: JAMA Surg Date: 2021-07-14 Impact factor: 14.766