Radiotherapy & Oncology
Volume 90, Issue 1 , Pages 74-79 , January 2009

High local recurrence risk is not associated with large survival reduction after postmastectomy radiotherapy in high-risk breast cancer: A subgroup analysis of DBCG 82 b&c

  • Marianne Kyndi

      Affiliations

    • Department of Experimental Clinical Oncology, Aarhus University Hospital, Denmark
    • Department of Pathology, Aarhus University Hospital, Denmark
    • Corresponding Author InformationCorresponding author. Department of Experimental Clinical Oncology, Aarhus University Hospital, Århus Sygehus, Noerrebrogade 44, Building 5, 2, DK-8000 Aarhus C, Denmark.
    • ,
  • Marie Overgaard

      Affiliations

    • Department of Oncology, Århus University Hospital, Denmark
    • ,
  • Hanne M. Nielsen

      Affiliations

    • Department of Experimental Clinical Oncology, Aarhus University Hospital, Denmark
    • ,
  • Flemming B. Sørensen

      Affiliations

    • Department of Pathology, Aarhus University Hospital, Denmark
    • ,
  • Helle Knudsen

      Affiliations

    • Department of Pathology, Herlev Hospital, Denmark
    • ,
  • Jens Overgaard

      Affiliations

    • Department of Experimental Clinical Oncology, Aarhus University Hospital, Denmark

Received 26 April 2008 ,Revised 28 April 2008 ,Accepted 28 April 2008.

References 

  1. Halsted WS. The results of radical operations for the cure of carcinoma of the breast. Ann Surg. 1907;46:1
  2. Fisher B. Laboratory and clinical research in breast cancer – a personal adventure. Cancer Res. 1980;40:3863–3874
  3. Hellman S. Karnofsky Memorial Lecture. Natural history of small breast cancers. J Clin Oncol. 1994;12:2229–2234
  4. Clarke M, Collins R, Darby S, et al. Effects of radiotherapy and of differences in the extent of surgery for early breast cancer on local recurrence and 15-year survival: an overview of the randomised trials. Lancet. 2005;366:2087–2106
  5. Punglia RS, Morrow M, Winer EP, Harris JR. Local therapy and survival in breast cancer. N Engl J Med. 2007;356:2399–2405
  6. Chung CS, Harris JR. Post-mastectomy radiation therapy: translating local benefits into improved survival. Breast. 2007;16:S78–S83
  7. Goldhirsch A, Glick JH, Gelber RD, Senn HJ. Meeting highlights: International Consensus Panel on the Treatment of Primary Breast Cancer. J Natl Cancer Inst. 1998;90:1601–1608
  8. Harris JR, Halpin-Murphy P, McNeese M, Mendenhall NP, Morrow M, Robert NJ. Consensus Statement on postmastectomy radiation therapy. Int J Radiat Oncol Biol Phys. 1999;44:989–990
  9. Recht A, Edge SB, Solin LJ, et al. Postmastectomy radiotherapy: clinical practice guidelines of the American Society of Clinical Oncology. J Clin Oncol. 2001;19:1539–1569
  10. Goldhirsch A, Glick JH, Gelber RD, Coates AS, Senn HJ. Meeting highlights: International Consensus Panel on the Treatment of Primary Breast Cancer. In: Seventh International Conference on Adjuvant Therapy of Primary Breast Cancer. J Clin Oncol 2001;19:3817–27.
  11. Eifel P, Axelson JA, Costa J, et al. National Institutes of Health Consensus Development Conference Statement: adjuvant therapy for breast cancer, November 1–3, 2000. J Natl Cancer Inst. 2001;93:979–989
  12. Kurtz J. The curative role of radiotherapy in the treatment of operable breast cancer. Eur J Cancer. 2002;38:1961–1974
  13. Goldhirsch A, Wood WC, Gelber RD, Coates AS, Thurlimann B, Senn HJ. Meeting highlights: updated international expert consensus on the primary therapy of early breast cancer. J Clin Oncol. 2003;21:3357–3365
  14. Truong PT, Olivotto IA, Whelan TJ, Levine M. Clinical practice guidelines for the care and treatment of breast cancer: 16. Locoregional post-mastectomy radiotherapy. CMAJ. 2004;170:1263–1273
  15. Goldhirsch A, Glick JH, Gelber RD, Coates AS, Thurlimann B, Senn HJ. Meeting highlights: international expert consensus on the primary therapy of early breast cancer 2005. Ann Oncol. 2005;16:1569–1583
  16. Overgaard M, Hansen PS, Overgaard J, et al. Postoperative radiotherapy in high-risk premenopausal women with breast cancer who receive adjuvant chemotherapy. Danish Breast Cancer Cooperative Group 82b Trial. N Engl J Med. 1997;337:949–955
  17. Overgaard M, Jensen MB, Overgaard J, et al. Postoperative radiotherapy in high-risk postmenopausal breast-cancer patients given adjuvant tamoxifen: Danish Breast Cancer Cooperative Group DBCG 82c randomised trial. Lancet. 1999;353:1641–1648
  18. Nielsen HM, Overgaard M, Grau C, Jensen AR, Overgaard J. Study of failure pattern among high-risk breast cancer patients with or without postmastectomy radiotherapy in addition to adjuvant systemic therapy: long-term results from the Danish Breast Cancer Cooperative Group DBCG 82 b and c randomized studies. J Clin Oncol. 2006;24:2268–2275
  19. Kyndi M, Sorensen FB, Knudsen H, et al. Tissue microarrays compared with whole sections and biochemical analyses. A subgroup analysis of DBCG82 b&c. Acta Oncol. 2008;47:591–599
  20. Bloom HJ, Richardsson WW. Histological grading and prognosis in breast cancer; a study of 1409 cases of which 359 have been followed for 15years. Br J Cancer. 1957;11:359–377
  21. Effects of radiotherapy and surgery in early breast cancer. An overview of the randomized trials. Early Breast Cancer Trialists’ Collaborative Group. N Engl J Med 1995;333:1444–55.
  22. Cuzick J, Stewart H, Peto R, et al. Overview of randomized trials of postoperative adjuvant radiotherapy in breast cancer. Cancer Treat Rep. 1987;71:15–29
  23. Cuzick J, Stewart H, Rutqvist L, et al. Cause-specific mortality in long-term survivors of breast cancer who participated in trials of radiotherapy. J Clin Oncol. 1994;12:447–453
  24. Favourable and unfavourable effects on long-term survival of radiotherapy for early breast cancer: an overview of the randomised trials. Early Breast Cancer Trialists’ Collaborative Group. Lancet 2000;355:1757–770.
  25. Overgaard M. Overview of randomized trials in high risk breast cancer patients treated with adjuvant systemic therapy with or without postmastectomy irradiation. Semin Radiat Oncol. 1999;9:292–299
  26. Whelan T, Levine M. More evidence that locoregional radiation therapy improves survival: what should we do?. J Natl Cancer Inst. 2005;97:82–84
  27. Overgaard M, Nielsen HM, Overgaard J. Is the benefit of postmastectomy irradiation limited to patients with four or more positive nodes, as recommended in international consensus reports? A subgroup analysis of the DBCG 82 b&c randomized trials. Radiother Oncol. 2007;82:247–253
  28. Ragaz J, Olivotto IA, Spinelli JJ, et al. Locoregional radiation therapy in patients with high-risk breast cancer receiving adjuvant chemotherapy: 20-year results of the British Columbia randomized trial. J Natl Cancer Inst. 2005;97:116–126
  29. Hojris I, Overgaard M, Christensen JJ, Overgaard J. Morbidity and mortality of ischaemic heart disease in high-risk breast-cancer patients after adjuvant postmastectomy systemic treatment with or without radiotherapy: analysis of DBCG 82b and 82c randomised trials. Radiotherapy Committee of the Danish Breast Cancer Cooperative Group. Lancet. 1999;354:1425–1430
  30. Kyndi M, Sorensen FB, Knudsen H, Overgaard M, Nielsen HM, Overgaard J. Estrogen receptor, progesterone receptor, HER-2, and response to postmastectomy radiotherapy in high-risk Breast Cancer: The Danish Breast Cancer Cooperative Group. J Clin Oncol. 2008;26:1419–1426

☆ The study was conducted on behalf of the DBCG (Danish Breast Cancer Cooperative Group).

PII: S0167-8140(08)00235-1

doi: 10.1016/j.radonc.2008.04.014

Radiotherapy & Oncology
Volume 90, Issue 1 , Pages 74-79 , January 2009

Article Tools

* Image Usage & Resolution