scholarly journals Does adjuvant radiation therapy benefit women with small mammography-detected breast cancers?

2017 ◽  
Vol 24 (1) ◽  
pp. 28
Author(s):  
K. Jerzak ◽  
N. Dudalski ◽  
K. Pritchard ◽  
P. Sun ◽  
S.A. Narod
Keyword(s):  
Radiation Therapy ◽  
Local Recurrence ◽  
Cox Regression ◽  
Tumour Size ◽  
Demographic Data ◽  
Breast Conserving Surgery ◽  
Adjuvant Radiation ◽  
Breast Cancers ◽  
Adjuvant Radiation Therapy ◽  
Actuarial Risk

Background Women with small nonpalpable breast tumours have an excellent prognosis. The benefit of radiotherapy in this group of low-risk women is unknown.Methods A cohort of 1595 women with stages i–iii invasive breast cancer treated with breast-conserving surgery were followed for local recurrence. Using t-tests, baseline demographic data and tumour characteristics were compared forthe women who had palpable (n = 1023) and mammography-detected (n = 572) breast cancers. The 15-year actuarial risk of local recurrence was estimated using a Kaplan–Meier method, stratified for adjuvant radiation therapy (yes or no), tumour palpability (palpable or not), and tumour size (≤1 cm or >1 cm). Hazard ratios (hrs) and 95% confidence intervals (95% cis) were calculated using a multivariate Cox regression model. Results were considered statistically significant if 2-tailed p values were less than 0.05.Results Among women with a nonpalpable tumour, the 15-year actuarial rates of local recurrence were, respectively, 13.9% and 18.3% for those treated and not treated with adjuvant radiation therapy (hr: 0.65; 95%ci: 0.40 to 1.06; p = 0.08). Among women with small nonpalpable breast cancers (≤1.0 cm), the rates were 14.6% and 13.4% respectively (p = 0.67). The absolute reduction in 15-year local recurrence was 11.0% for women with palpable tumours.Conclusions Our results suggest that women with small (<1 cm) screen-detected nonpalpable breast cancers likely derive little benefit from adjuvant radiotherapy; however, an adequately powered randomized trial would be required to make definitive conclusions.

Patients’ preferences for adjuvant radiation therapy in early breast cancers

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 11083-11083
Author(s):  
S. C. Pendlebury ◽  
V. Duric ◽  
D. Joseph ◽  
A. Rodger ◽  
A. Rodger ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Local Recurrence ◽  
Cancer Recurrence ◽  
Good Prognosis ◽  
Adjuvant Radiation ◽  
Breast Cancers ◽  
Recurrence Rates ◽  
Adjuvant Radiation Therapy ◽  
Direct Benefits ◽  
Women’S Preferences

11083 Background: Adjuvant radiation therapy (ART) reduces the risk of local recurrence in women with breast cancers. In good prognosis tumours in older women the absolute benefits are small. The aim of this study is to determine the smallest improvement in local recurrence rates that women would consider sufficient to make their adjuvant therapy worthwhile. Methods: 95 women who had completed ART 2–4 years earlier for T1N0M0 breast cancers had their preferences elicited by 1 of 3 interviewers. Women were presented 3 sets of hypothetical scenarios about the risks of recurrence with and without radiation using baseline risks of 5%, 10%,and 20%without ART. The order scenarios were presented was allocated randomly. Results: The women’s median age was 63 years 54% had dependants, and 58% travelled 20km or less to their ART centre. A 1% reduction in risk of local recurrence was judged sufficient to to make ART worthwhile by 77% of the women. More than half the women judged ART worthwhile even if it conferred no benefit. 3–8% of the women judged even the maximum possible benefits insufficient to make ART worthwhile. Women’s preferences were almost identical for all 3 scenarios(Spearman’s rank correlations of 0.89 to 0.94). Preferences were unaffected by the order of scenario presentation, interviewer, participants age, cancer recurrence prior to interview,support during ART, dependants, distance to travel to ART, or time since completing ART. Conclusions: Most women judged small benefits in local recurrence sufficient to make ART worthwhile. Many women judged negligible benefits sufficient suggesting the importance of considerations other than the trade-off between direct benefits and harms. No significant financial relationships to disclose.

scholarly journals Investigating confounders of the association between survival and adjuvant radiation therapy after breast conserving surgery in a sample of elderly breast Cancer patients in Appalachia

BMC Cancer ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Fabian Camacho ◽  
Roger Anderson ◽  
Gretchen Kimmick
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
Structural Model ◽  
Failure Time ◽  
Breast Conserving Surgery ◽  
Adjuvant Radiation ◽  
Percentage Increase ◽  
Adjuvant Radiation Therapy ◽  
Percent Change ◽  
Dual Status

Abstract Background To explain the association between adjuvant radiation therapy after breast conserving surgery (BCS RT) and overall survival (OS) by quantifying bias due to confounding in a sample of elderly breast cancer beneficiaries in a multi-state region of Appalachia. Methods We used Medicare claims linked registry data for fee-for-service beneficiaries with AJCC stage I-III, treated with BCS, and diagnosed from 2006 to 2008 in Appalachian counties of Kentucky, Ohio, North Carolina, and Pennsylvania. Confounders of BCS RT included age, rurality, regional SES, access to radiation facilities, marital status, Charlson comorbidity, Medicaid dual status, institutionalization, tumor characteristics, and surgical facility characteristics. Adjusted percent change in expected survival by BCS RT was examined using Accelerated Failure Time (AFT) models. Confounding bias was assessed by comparing effects between adjusted and partially adjusted associations using a fully specified structural model. Results The final sample had 2675 beneficiaries with mean age of 75, with 81% 5-year survival from diagnosis. Unadjusted percentage increase in expected survival was 2.75 times greater in the RT group vs. non-RT group, with 5-year survival of 85% vs 60%; fully adjusted percentage increase was 1.70 times greater, with 5-year rates of 83% vs 71%. Quantification of incremental confounding showed age accounted for 71% of the effect reduction, followed by tumor features (12%), comorbidity (10%), dual status(10%), and institutionalization (8%). Adjusting for age and tumor features only resulted in only 4% bias from fully adjusted percent change (70% change vs 66%). Conclusion Quantification of confounding aids in determining covariates to adjust for and in interpreting raw associations. Substantial confounding was present (60% of total association), with age accounting for the largest share (71%); adjusting for age plus tumor features corrected for most of the confounding (4% bias). The direct effect of BCS RT on OS accounted for 40% of the total association.

scholarly journals Adjuvant radiation therapy, local recurrence, and the need for salvage therapy in atypical meningioma

2014 ◽  
Vol 16 (11) ◽  
pp. 1547-1553 ◽  
Author(s):  
A. A. Aizer ◽  
N. D. Arvold ◽  
P. Catalano ◽  
E. B. Claus ◽  
A. J. Golby ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Local Recurrence ◽  
Salvage Therapy ◽  
Atypical Meningioma ◽  
Adjuvant Radiation ◽  
Adjuvant Radiation Therapy

Predictors of adjuvant radiation therapy in the treatment of male breast cancer and its impact on outcomes: A propensity matched analysis.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e12516-e12516
Author(s):  
Veli Bakalov ◽  
Thejus Thayyil Jayakrishnan ◽  
Stephen Abel ◽  
Christie Hilton ◽  
Bindu Rusia ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
Male Breast Cancer ◽  
Cox Regression ◽  
Breast Conservation ◽  
Male Breast ◽  
Breast Conservation Surgery ◽  
P Value ◽  
Adjuvant Radiation ◽  
Adjuvant Radiation Therapy

e12516 Background: Male breast cancer (MBC) accounts for 1% of all breast cancers and there is a paucity of data on factors impacting the treatment strategies and outcomes. We hypothesized that adjuvant radiation therapy (Adj-RT) may improve survival outcomes and sought to examine predictive factors for Adj-RT receipt. Methods: We queried the National Cancer Database (NCDB) for patients with stages I-III MBC treated with surgery (breast conservation surgery- BCS or mastectomy-MS) within 180 days of diagnosis (years 2004-2015). Multivariable logistic regression identified predictors of adjuvant radiation therapy receipt. Multivariable Cox regression evaluated predictors of survival. Propensity matching for adj-RT accounted for indication biases. Results: We identified 6,217 patients meeting the eligibility criteria (1457 BCS vs. 4760 MS). The majority of patients were white (85%) and within the age range of 50-80 years (74%). Although Adj-RT was omitted for 30% of BCS patients, the utilization was higher compared to MS (OR=26, p-value=0.001). The predictors of Adj-RT use were – African American race, higher stage, higher grade, presence of lymphovascular invasion and ER/Her-2 positivity for the entire cohort and higher age, urban location and higher income for BCS. Adj-RT was associated with lower mortality in the propensity matched model (overall HR for BCS=0.28, p-value<0.001; overall HR for MS=0.62,p-value=0.001) and is shown in the table. Conclusions: This study demonstrates there may be an association between decreased mortality and Adj-RT in MBC undergoing BCS. Although this implies that Adj-RT should be routinely delivered, it appears to be omitted frequently and its use requires further investigation. The study also suggests a benefit to Adj-Rt after MS for stage-III MBC. [Table: see text]

Local Recurrence after Mastectomy and Adjuvant CMF: Implications for Adjuvant Radiation Therapy

2000 ◽  
Vol 70 (9) ◽  
pp. 649-655 ◽  
Author(s):  
Anna M. Rangan ◽  
Verity Ahern ◽  
Desmond Yip ◽  
John Boyages
Keyword(s):  
Radiation Therapy ◽  
Local Recurrence ◽  
Adjuvant Radiation ◽  
Adjuvant Radiation Therapy
Sign in / Sign up

Export Citation Format

Share Document