Abstract P4-10-03: Long-Term Follow-Up of SweBCG 91RT, a Randomized Trial of Breast Conservation Surgery with and without Radiotherapy from the Swedish Breast Cancer Group

2010 ◽  
Author(s):  
P Malmström ◽  
F Killander ◽  
H Anderson ◽  
E Holmberg ◽  
D Lundstedt ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Randomized Trial ◽  
Breast Conservation ◽  
Breast Conservation Surgery ◽  
Cancer Group ◽  
Conservation Surgery ◽  
Long Term Follow Up ◽  
Breast Cancer Group

Mastectomy versus breast conservation surgery: Mental health effects at long-term follow-up.

1992 ◽  
Vol 11 (6) ◽  
pp. 349-354 ◽  
Author(s):  
Sandra M. Levy ◽  
Lathrop T. Haynes ◽  
Ronald B. Herberman ◽  
Jerry Lee ◽  
Sheila McFeeley ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Effects ◽  
Breast Conservation ◽  
Breast Conservation Surgery ◽  
Conservation Surgery ◽  
Long Term Follow Up ◽  
Mental Health Effects

scholarly journals Response to Radiotherapy After Breast-Conserving Surgery in Different Breast Cancer Subtypes in the Swedish Breast Cancer Group 91 Radiotherapy Randomized Clinical Trial

2017 ◽  
Vol 35 (28) ◽  
pp. 3222-3229 ◽  
Author(s):  
Martin Sjöström ◽  
Dan Lundstedt ◽  
Linda Hartman ◽  
Erik Holmberg ◽  
Fredrika Killander ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Triple Negative ◽  
Breast Conservation ◽  
Growth Factor Receptor ◽  
Low Risk ◽  
Breast Conservation Surgery ◽  
Luminal A ◽  
Cancer Subtypes ◽  
Cancer Group ◽  
Breast Cancer Group

Purpose To evaluate the effect of adjuvant radiotherapy (RT) after breast conservation surgery in different breast cancer subtypes in a large, randomized clinical trial with long-term follow-up. Patients and Methods Tumor tissue was collected from 1,003 patients with node-negative, stage I and II breast cancer who were randomly assigned in the Swedish Breast Cancer Group 91 Radiotherapy trial between 1991 and 1997 to breast conservation surgery with or without RT. Systemic adjuvant treatment was sparsely used (8%). Subtyping was performed with immunohistochemistry and in situ hybridization on tissue microarrays for 958 tumors. Results RT reduced the cumulative incidence of ipsilateral breast tumor recurrence (IBTR) as a first event within 10 years for luminal A–like tumors (19% v 9%; P = .001), luminal B–like tumors (24% v 8%; P < .001), and triple-negative tumors (21% v 6%; P = .08), but not for human epidermal growth factor receptor 2–positive (luminal and nonluminal) tumors (15% v 19%; P = .6); however, evidence of an overall difference in RT effect between subtypes was weak ( P = .21). RT reduced the rate of death from breast cancer (BCD) for triple-negative tumors (hazard ratio, 0.35; P = .06), but not for other subtypes. Death from any cause was not improved by RT in any subtype. A hypothesized clinical low-risk group did not have a low risk of IBTR without RT, and RT reduced the rate of IBTR as a first event after 10 years (20% v 6%; P = .008), but had no effect on BCD or death from any cause. Conclusion Subtype was not predictive of response to RT, although, in our study, human epidermal growth factor receptor 2–positive tumors seemed to be most radioresistant, whereas triple-negative tumors had the largest effect on BCD. The effect of RT in the presumed low-risk luminal A–like tumors was excellent.

scholarly journals Audit of local recurrence following breast conservation surgery with 5-mm target margin and hypofractionated 40-Gray breast radiotherapy for invasive breast cancer

2010 ◽  
Vol 92 (7) ◽  
pp. 562-568 ◽  
Author(s):  
Siong-Seng Liau ◽  
Massimiliano Cariati ◽  
David Noble ◽  
Charles Wilson ◽  
Gordon C Wishart
Keyword(s):  
Breast Cancer ◽  
Invasive Breast Cancer ◽  
Breast Conservation ◽  
Breast Conserving Surgery ◽  
Breast Conservation Surgery ◽  
Breast Cancer Specific Survival ◽  
Breast Radiotherapy ◽  
Cancer Specific Survival ◽  
Conservation Surgery

INTRODUCTION The risk of ipsilateral breast tumour recurrence (IBTR) following breast conservation surgery (BCS) for invasive breast cancer (IBC) and radiotherapy is dependent on patient-, tumour- and treatment-related variables. In the Cambridge Breast Unit, breast conserving surgery has been performed with a target radial margin of 5 mm for IBC, in combination with 40-Gy hypofractionated (15 fractions) breast radiotherapy, since 1999. PATIENTS AND METHODS An audit was performed of cases treated between 1999 and 2004. A total of 563 patients underwent BCS for invasive breast cancer with 90.4% receiving radiotherapy (RT) and 60.4% of patients receiving boost RT (3 fractions of 3-Gy). RESULTS After a median follow-up of 58 months, five of the 563 (0.9%) patients developed IBTR. The 5-year actuarial IBTR rate was 1.1%. In terms of distant disease recurrence (DDR), 29 of the 563 (5.2%) had DDR during follow-up, giving a 5-year actuarial DDR rate of 5.4%. The 5-year breast cancer specific survival was 95%, with the poorer NPI groups having worse breast cancer specific survival (Log-rank, P < 0.0001). More importantly, patients with IBTR had a shorter breast cancer-specific survival than those who were IBTR-free (Log-rank, P < 0.0001). CONCLUSIONS Our treatment regimen, combining BCS with a 5-mm target margin and hypofractionated 40-Gy RT, results in an extremely low rate of IBTR, and compares favourably with the target IBTR rate of < 5% defined by the Association of Breast Surgeons (ABS) at BASO guidelines.

Breast conservation surgery (BCS) for breast cancer in a resource limited country- Are we upto the challenge!

2022 ◽  
Vol 71 (12) ◽  
pp. 2748-2754
Author(s):  
Nida Javed ◽  
Bushra Rehman ◽  
Ejaz Iqbal ◽  
Sidra Afzal ◽  
Aun Jamal ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Breast Conservation ◽  
Disease Free Survival ◽  
Breast Conservation Surgery ◽  
Progesterone Receptor Status ◽  
Free Survival ◽  
Conservation Surgery ◽  
Disease Free

Objective: To analyse outcomes of breast conservation surgery and to identify the factors that could have affected the outcomes. Method: The retrospectively study was conducted at the Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan, and comprised data of breast conservation surgery cases done between January 2011 and October 2014 in order to cover up for the 5-year follow-up of the last enrolled patient. Data, obtained through the institutional information and database system, included disease-recurrence, 5-year disease-free survival and overall survival. Data was statistically analysed using SPSS 20. Results: Of the 553 cases, 417(75%) had no loco-regional recurrence or distant metastasis, while 136(25%) had some form of loco-regional, distant or contralateral metastasis at 5-year follow-up. In patients who had recurrence or metastasis, only progesterone receptor status, nodal status and mode of treatment showed significant association (p<0.05). Mortality at 5-year follow-up was 77(14%). Amongst the patients who died, only progesterone receptor status and nodal status had significant association (p<0.05). Five-year overall survival for the cohort was 476(86%), whereas 5-year disease-free survival was 409(74%). Conclusion: Breast conservation surgery was found to have favourable outcomes, while progesterone status, nodal involvement and mode of treatment significantly affected the outcome. Key Words:  Breast cancer, Breast conserving surgery, 5-year disease free survival, 5-year overall survival Continuous...

Effect of Radiotherapy After Breast-Conserving Surgery Depending on the Presence of Tumor-Infiltrating Lymphocytes: A Long-Term Follow-Up of the SweBCG91RT Randomized Trial

2019 ◽  
Vol 37 (14) ◽  
pp. 1179-1187 ◽  
Author(s):  
Anikó Kovács ◽  
Axel Stenmark Tullberg ◽  
Elisabeth Werner Rönnerman ◽  
Erik Holmberg ◽  
Linda Hartman ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Randomized Trial ◽  
Ipsilateral Breast Tumor Recurrence ◽  
Tumor Infiltrating Lymphocytes ◽  
Breast Conserving Surgery ◽  
Cancer Group ◽  
Long Term Follow Up ◽  
Breast Cancer Group ◽  
Grade 3 ◽  
Infiltrating Lymphocytes

PURPOSE The effects of radiotherapy (RT) on the basis of the presence of stromal tumor infiltrating lymphocytes (TILs) have not been studied. The purpose of this study was to analyze the association of TILs with the effect of postoperative RT on ipsilateral breast tumor recurrence (IBTR) in a large randomized trial. METHODS In the SweBCT91RT (Swedish Breast Cancer Group 91 Radiotherapy) trial, 1,178 patients with breast cancer stage I and II were randomly assigned to breast-conserving surgery plus postoperative RT or breast-conserving surgery only and followed for a median of 15.2 years. Tumor blocks were retrieved from 1,003 patients. Stromal TILs were assessed on whole-section hematoxylin-eosin–stained slides using a dichotomized cutoff of 10%. Subtypes were scored using immunohistochemistry on tissue microarray. In total, 936 patients were evaluated. RESULTS Altogether, 670 (71%) of patients had TILs less than 10%. In a multivariable regression analysis with IBTR as dependent variable and RT, TILs, subtype, age, and grade as independent variables, RT (hazard ratio [HR], 0.42; 95% CI, 0.29 to 0.61; P < .001), high TILs (HR, 0.61; 95% CI, 0.39 to 0.96, P = .033) grade (3 v 1; HR, 2.17; 95% CI, 1.08 to 4.34; P = .029), and age (≥ 50 v < 50 years; HR, 0.55; 95% CI, 0.38 to 0.80; P = .002) were predictive of IBTR. RT was significantly beneficial in the low TILs group (HR, 0.37; 95% CI, 0.24 to 0.58; P < .001) but not in the high TILs group (HR, 0.58; 95% CI, 0.28 to 1.19; P = .138). The test for interaction between RT and TILs was not statistically significant ( P = .317). CONCLUSION This study shows that high values of TILs in the primary tumor independently seem to reduce the risk for an IBTR. Our findings further suggest that patients with breast cancer with low TILs may derive a larger benefit from RT regarding the risk of IBTR.

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