Lumpectomy Plus Tamoxifen With or Without Irradiation in Women Age 70 Years or Older With Early Breast Cancer: Long-Term Follow-Up of CALGB 9343

Purpose To determine whether there is a benefit to adjuvant radiation therapy after breast-conserving surgery and tamoxifen in women age ≥ 70 years with early-stage breast cancer. Patients and Methods Between July 1994 and February 1999, 636 women (age ≥ 70 years) who had clinical stage I (T1N0M0 according to TNM classification) estrogen receptor (ER) –positive breast carcinoma treated by lumpectomy were randomly assigned to receive tamoxifen plus radiation therapy (TamRT; 317 women) or tamoxifen alone (Tam; 319 women). Primary end points were time to local or regional recurrence, frequency of mastectomy, breast cancer–specific survival, time to distant metastasis, and overall survival (OS). Results Median follow-up for treated patients is now 12.6 years. At 10 years, 98% of patients receiving TamRT (95% CI, 96% to 99%) compared with 90% of those receiving Tam (95% CI, 85% to 93%) were free from local and regional recurrences. There were no significant differences in time to mastectomy, time to distant metastasis, breast cancer–specific survival, or OS between the two groups. Ten-year OS was 67% (95% CI, 62% to 72%) and 66% (95% CI, 61% to 71%) in the TamRT and Tam groups, respectively. Conclusion With long-term follow-up, the previously observed small improvement in locoregional recurrence with the addition of radiation therapy remains. However, this does not translate into an advantage in OS, distant disease-free survival, or breast preservation. Depending on the value placed on local recurrence, Tam remains a reasonable option for women age ≥ 70 years with ER-positive early-stage breast cancer.

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Fatigue in patients with adjuvant radiation therapy for breast cancer: long-term follow-up

Journal of Cancer Research and Clinical Oncology ◽

10.1007/s00432-003-0540-9 ◽

2004 ◽

Vol 130 (6) ◽

pp. 327-333 ◽

Cited By ~ 59

Author(s):

Hans Geinitz ◽

Frank B. Zimmermann ◽

Reinhard Thamm ◽

Monika Keller ◽

Raymonde Busch ◽

...

Keyword(s):

Breast Cancer ◽

Radiation Therapy ◽

Adjuvant Radiation ◽

Adjuvant Radiation Therapy ◽

Long Term Follow Up

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Retinoid X receptor gamma (RXRG) is an independent prognostic biomarker in ER-positive invasive breast cancer

British Journal of Cancer ◽

10.1038/s41416-019-0589-0 ◽

2019 ◽

Vol 121 (9) ◽

pp. 776-785 ◽

Cited By ~ 2

Author(s):

Chitra Joseph ◽

Sara Al-Izzi ◽

Mansour Alsaleem ◽

Sasagu Kurozumi ◽

Michael S Toss ◽

...

Keyword(s):

Breast Cancer ◽

Patient Outcome ◽

Distant Metastasis ◽

Prognostic Significance ◽

Retinoid X Receptor ◽

Cancer Tissue ◽

Lower Grade ◽

Breast Cancer Specific Survival ◽

Cancer Specific Survival ◽

Er Positive

Abstract Background Retinoid X Receptor Gamma (RXRG) is a member of the nuclear receptor superfamily and plays a role in tumour suppression. This study aims to explore the prognostic significance of RXRG in breast cancer. Methods Primary breast cancer tissue microarrays (n = 923) were immuno-stained for RXRG protein and correlated with clinicopathological features, and patient outcome. Results Nuclear RXRG expression was significantly associated with smaller tumour size (p = 0.036), lower grade (p < 0.001), lobular histology (p = 0.016), lower Nottingham Prognostic Index (p = 0.04) and longer breast cancer-specific survival (p < 0.001), and longer time to distant metastasis (p = 0.002). RXRG expression showed positive association with oestrogen receptor (ER)-related biomarkers: GATA3, FOXA1, STAT3 and MED7 (all p < 0.001) and a negative correlation with the Ki67 proliferation marker. Multivariate analysis demonstrated RXRG protein as an independent predictor of longer breast cancer-specific survival and distant metastasis-free survival. In the external validation cohorts, RXRG expression was associated with improved patients’ outcome (p = 0.025). In ER-positive tumours, high expression of RXRG was associated with better patient outcome regardless of adjuvant systemic therapy. ER signalling pathway was the top predicted master regulator of RXRG protein expression (p = 0.005). Conclusion This study provides evidence for the prognostic value of RXRG in breast cancer particularly the ER-positive tumours.

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Abstract P2-12-09: Long-term follow-up of nipple-sparing mastectomy for early-stage breast cancer without radiotherapy: A single-center study at a Japanese institution

10.1158/1538-7445.sabcs15-p2-12-09 ◽

2016 ◽

Author(s):

T Sakurai ◽

T Suzuma ◽

G Yoshimura ◽

E Jinta ◽

T Umemura ◽

...

Keyword(s):

Breast Cancer ◽

Early Stage ◽

Single Center ◽

Single Center Study ◽

Long Term Follow Up ◽

Nipple Sparing Mastectomy ◽

Nipple Sparing ◽

Center Study

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Prognostic value of PAM50 and risk of recurrence score in patients with early-stage breast cancer with long-term follow-up

Breast Cancer Research ◽

10.1186/s13058-017-0911-9 ◽

2017 ◽

Vol 19 (1) ◽

Cited By ~ 27

Author(s):

Hege O. Ohnstad ◽

Elin Borgen ◽

Ragnhild S. Falk ◽

Tonje G. Lien ◽

Marit Aaserud ◽

...

Keyword(s):

Breast Cancer ◽

Prognostic Value ◽

Early Stage ◽

Recurrence Score ◽

Early Stage Breast Cancer ◽

Risk Of Recurrence ◽

Long Term Follow Up

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Surgery versus primary endocrine therapy for elderly women with estrogen receptor-positive early operable primary breast cancer: Survival analysis and correlation with oestrogen receptor positivity

Journal of Clinical Oncology ◽

10.1200/jco.2009.27.15_suppl.612 ◽

2009 ◽

Vol 27 (15_suppl) ◽

pp. 612-612

Author(s):

B. M. Syed ◽

S. J. Johnston ◽

D. W. M. Wong ◽

D. A. L. Morgan ◽

I. O. Ellis ◽

...

Keyword(s):

Breast Cancer ◽

Endocrine Therapy ◽

Primary Breast Cancer ◽

Oestrogen Receptor ◽

Elderly Women ◽

Breast Cancer Specific Survival ◽

Cancer Specific Survival ◽

Er Positive ◽

Primary Endocrine Therapy

612 Background: A recent Cochrane review of seven randomised trials involving 1,446 elderly women (unselected for oestrogen receptor (ER) status) has shown no significant difference in overall survival between surgery (with or without adjuvant tamoxifen) and primary endocrine therapy using tamoxifen. We now report results of a large series from a single centre with a dedicated elderly breast cancer service, with long term follow-up. Methods: During a period of > 20 years, 1,031 elderly (> 70 years) women with ER positive (H-score >50) early operable primary breast cancer received either surgery (with or without adjuvant endocrine therapy) (N = 436) or primary endocrine therapy (N = 595) (>80% using tamoxifen) as initial treatment, with complete follow-up information till deaths. The initial treatment was decided based on fitness for surgery and patient choice. Analysis was carried out on breast cancer specific survival and degree of ER positivity. Results: After a median follow up of 49 months (range 0 - 261 months), patients between 70 - 80 years, treated by surgery, had better 5-year breast cancer specific survival compared to their counterparts treated by primary endocrine therapy (95% versus 85%; p < 0.001). For patients > 80 years, there was however no statistical difference between the two groups (90% versus 90%; p = 0.813). The median survival has not reached yet in all groups. Patients in the latter group (> 80 years) were found to have a higher chance of having strongly ER positive tumours (57% versus 50% in patients between 70 - 80 years with H-score >200; p- < 0.02). Conclusions: In a selected group of elderly women (> 80 years) who tend to have strongly ER positive tumours, surgery and primary endocrine therapy did not appear to produce any difference in breast cancer specific survival. This subject is currently being investigated in a national randomised trial in the UK. No significant financial relationships to disclose.

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