Omitting adjuvant radiotherapy for hormone receptor-positive early-stage breast cancer in old age: A propensity score matched SEER analysis

Yi Jun Kim, Kyung Hwan Shin, Kyubo Kim

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

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).

Original languageEnglish
Pages (from-to)326-336
Number of pages11
JournalCancer Research and Treatment
Volume51
Issue number1
DOIs
StatePublished - 1 Jan 2019

Keywords

  • Adjuvant radiotherapy
  • Aged
  • Breast neoplasms
  • Estrogen receptors
  • Progesterone receptors
  • SEER database
  • Tumor grade
  • Tumor size

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