Do All Patients Require Radiotherapy after Breast-Conserving Surgery?
Abstract
:1. Introduction
2. Methods
3. Results
3.1. Meta-Analyses
3.2. Randomized Controlled Trials
Author/Group | Trial period | Patients | Age | Tumor | Grade | % node | Surgery | Margins | Systemic therapy | Follow-up | Local recurrence | |
---|---|---|---|---|---|---|---|---|---|---|---|---|
restrictions | Size cm | positive | BCS | BCS + RT | ||||||||
Randomized controlled trials | ||||||||||||
Fisher et al. | 1976–1984 | 1137 | None | ≤4 | All | 35.4 | WLE | R0 | N1 only | 20 years | 27.9 | 7.7 |
NSABP B-06[2] | 23.5 (N0) | 10.4 (N0) | ||||||||||
Liljegren et al. | 1981–1988 | 381 | None | ≤2 | All | 0 | Quad | R0 | None | 5 years | 18.4 | 2.3 |
Uppsala-Orebro[20] | ||||||||||||
Veronesi et al. | 1987–1989 | 579 | None | ≤2.5 | All | 30.3 | Quad | R0 | N1 post-menopausal | 10 years | 23.5 | 5.8 |
Milan III[11] | received TAM | |||||||||||
Clark et al. | 1984–1989 | 837 | None | ≤4 | All | None | WLE | R0 | None | 43 months | 25.7 | 5.5 |
Ontario[12] | (0.5–1 cm) | Median | ||||||||||
Renton et al. | 1981–1990 | 418 | None | ≤5 | All | WLE | Included | Yes if node positive or ER-ve | 35 | 13 | ||
British[13] | incomplete | 5 years | ||||||||||
Forrest et al. | 1985–1991 | 585 | <70 | ≤4 | All | 22.9 | WLE | 1 cm | All if ER + ve | 5.7 median | 24.5 | 5.8 |
Scottish CTBG[21] | ||||||||||||
Hughes et al. | 1994–1999 | 636 | >70 | ≤2 | All | None | WLE | R0 | TAM 5 years | 5 years median | 4 | 1 |
CALBG | ||||||||||||
CALBG update C9343[18] | 1994–1999 | 636 | >70 | ≤2 | All | TAM 5 years | 7–9 | 6.3 | 1 | |||
Spooner et al. | 1995– | 707 | ≤4 | All | None | WLE | R0 | 2 years | 13 | 4 | ||
West Midland[22]s | ||||||||||||
Fyles et al. | 1992–2000 | 769 | None | ≤5 | All | None | WLE | R0 | TAM 5 years | 5.6 years | 7.7 | 0.6 |
Canadian[19] | Subgroup | ≤2 | Median | 5.9 | 0.4 | |||||||
NSABP B-21[23] | 1989–1998 | 1009 | None | ≤1 | All | WLE | >1 cm | TAM 5 years | 8 years | 16.5 | 2.8 | |
BASO II[24]* | 2004– | 1062 | None | ≤2 | All | None | WLE | R0 | TAM 5 years | 4 years | 5 | 2 |
PRIME II[15]* | 2004– | >240 | >65 | 3 | I,II | None | WLE | R0 | All if ER + ve for 5 years | 5 years | ||
Holli et al[25]. | 1990–1999 | 264 | >40 | ≤2 | I, II | None | WLE | 1 cm | None | 12 years | 27 | 12 |
Tinterri et al[26]. | 2001–2005 | 749 | 55–75 | <2.5 cm | NS | 16 v 14 | WLE | R0 | Yes if node positive | 53 months | 2.7 | 0.7 |
Winzer et al.[27] | 1991–1998 | 347 | 45–75 | ≤2 | I,II | None | WLE | R0 | Randomized to TAM | 9.9 years | 34 | 0.09 |
With TAM | 0.08 | 0.07 |
3.3. Non-Randomized Studies
3.4. What Factors Can Be Considered Low Risk?
4. Conclusions
References
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Skandarajah, A.R.; Mann, G.B. Do All Patients Require Radiotherapy after Breast-Conserving Surgery? Cancers 2010, 2, 740-751. https://doi.org/10.3390/cancers2020740
Skandarajah AR, Mann GB. Do All Patients Require Radiotherapy after Breast-Conserving Surgery? Cancers. 2010; 2(2):740-751. https://doi.org/10.3390/cancers2020740
Chicago/Turabian StyleSkandarajah, Anita R., and G. Bruce Mann. 2010. "Do All Patients Require Radiotherapy after Breast-Conserving Surgery?" Cancers 2, no. 2: 740-751. https://doi.org/10.3390/cancers2020740