TY - JOUR
T1 - Omitting adjuvant radiotherapy for hormone receptor-positive early-stage breast cancer in old age
T2 - A propensity score matched SEER analysis
AU - Kim, Yi Jun
AU - Shin, Kyung Hwan
AU - Kim, Kyubo
N1 - Publisher Copyright:
Copyright © 2019 by the Korean Cancer Association
PY - 2019/1/1
Y1 - 2019/1/1
N2 - Purpose: The purpose of this study was to investigate the non-inferiority of omitting radiotherapy (RT) after breast-conserving surgery (BCS) for hormone receptor (HR)-positive T1N0 breast cancer in elderly women. Materials and Methods: From 2004 to 2014, HR-positive T1N0 breast cancer patients aged 50 years or older and receiving BCS were retrieved from the Surveillance, Epidemiology, and End Results 18 database. After propensity score matching between the no-RT and RT groups, univariate and multivariate analyses were performed. Identified prognostic factors were used to stratify the risk groups. In each risk group, 10-year cancer-specific survival (CSS) rates were compared between the no-RT and RT groups. Results: After propensity score matching, the numbers of patients in the no-RT and RT groups were both 18,586. For patients who satisfied both a tumor size of 1-10 mm and a tumor grade of 1-2, omitting RT did not decrease the CSS rate at any age group, ranging from ≥ 50 to ≥ 85 years; for patients aged ≥ 50 years, the 10-year CSS rates in the no-RT and RT groups were 97.2% and 96.8%, respectively (adjusted hazard ratio, 0.862; p=0.312). However, for patients with a tumor size of 11-20 mm or tumor grade of 3-4, RT significantly increased the CSS rate irrespective of age. Conclusion RT after BCS for HR-positive T1N0 breast cancer in elderly women might be omitted without causing a decrease in the CSS rate, but only in patients who satisfy both a small tumor size (≤ 10 mm) and low tumor grade (1-2).
AB - Purpose: The purpose of this study was to investigate the non-inferiority of omitting radiotherapy (RT) after breast-conserving surgery (BCS) for hormone receptor (HR)-positive T1N0 breast cancer in elderly women. Materials and Methods: From 2004 to 2014, HR-positive T1N0 breast cancer patients aged 50 years or older and receiving BCS were retrieved from the Surveillance, Epidemiology, and End Results 18 database. After propensity score matching between the no-RT and RT groups, univariate and multivariate analyses were performed. Identified prognostic factors were used to stratify the risk groups. In each risk group, 10-year cancer-specific survival (CSS) rates were compared between the no-RT and RT groups. Results: After propensity score matching, the numbers of patients in the no-RT and RT groups were both 18,586. For patients who satisfied both a tumor size of 1-10 mm and a tumor grade of 1-2, omitting RT did not decrease the CSS rate at any age group, ranging from ≥ 50 to ≥ 85 years; for patients aged ≥ 50 years, the 10-year CSS rates in the no-RT and RT groups were 97.2% and 96.8%, respectively (adjusted hazard ratio, 0.862; p=0.312). However, for patients with a tumor size of 11-20 mm or tumor grade of 3-4, RT significantly increased the CSS rate irrespective of age. Conclusion RT after BCS for HR-positive T1N0 breast cancer in elderly women might be omitted without causing a decrease in the CSS rate, but only in patients who satisfy both a small tumor size (≤ 10 mm) and low tumor grade (1-2).
KW - Adjuvant radiotherapy
KW - Aged
KW - Breast neoplasms
KW - Estrogen receptors
KW - Progesterone receptors
KW - SEER database
KW - Tumor grade
KW - Tumor size
UR - http://www.scopus.com/inward/record.url?scp=85059913037&partnerID=8YFLogxK
U2 - 10.4143/crt.2018.163
DO - 10.4143/crt.2018.163
M3 - Article
C2 - 29747486
AN - SCOPUS:85059913037
SN - 1598-2998
VL - 51
SP - 326
EP - 336
JO - Cancer Research and Treatment
JF - Cancer Research and Treatment
IS - 1
ER -