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Title:
Treatment outcome of breast-conserving therapy in patients with positive or close resection margins: Japanese multi institute survey for radiation dose effect | Breast Cancer
Description:
Background The relationship between a positive resection margin and the risk of ipsilateral breast tumor recurrence (IBTR) is controversial. To evaluate the radiation dose and other factors influencing the ipsilateral breast tumor control (IBTC) in patients with positive or close resection margins after breast conserving surgery (BCS), the Japanese Radiation Oncology Study Group GROSG) S-99-3 study group conducted a multi-institute survey of these patients. Methods The patients with less than 5 mm tumor-free margins after BCS were eligible for this study. A total of 971 patients from 18 institutes were enrolled in the analysis. The final pathological margin status was classified into 3 groups. Radiation doses to the tumor bed were less than 60 Gy in 252 patients, 60 Gy in 456 patients and more than 60 Gy in 233 patients. Results IBTR was observed in 55 patients (5.8%). The IBTC rates at 5 and 10 years by the Kaplan Meier method were 95.6% and 87.3%, respectively. There was no significant difference in 10-year IBTC rates according to marginal status; 85.9% in positive margin patients, 91.0% in equal or less than 2 mm margin patients and 87.0% in 2.1β5 mm margin patients. Radiation dose to the tumor bed was a marginally significantly associated with the 10-year IBTC rate (β₯60 Gy 90.8% vs <60 Gy 84.2%,p=0.057). In patients with positive margins, IBTC with radiation dose equal to or more than 60 Gy was significantly better (p= 0.039). The other factors influencing the IBTC were age (β₯35 years vs <35 years:p<0.0001), menopausal status (p<0.0001) and tumor size (p=0.023). Conclusions In patients with positive margins, IBTC with radiation dose equal to or more than 60 Gy was significantly better than the others. We recommend that the tumor bed be irradiated with at least 60 Gy in the patients with positive margins. Further follow-up is necessary to draw final conclusions.
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breast, article, patients, google, scholar, pubmed, cancer, radiation, margin, cas, margins, tumor, recurrence, positive, breastconserving, therapy, oncol, dose, ibtc, status, treatment, karasawa, ipsilateral, conserving, surgery, oncology, treated, local, japan, access, stage, privacy, cookies, content, resection, japanese, mitsumori, study, radiotherapy, radiat, biol, phys, department, radiology, analysis, publish, research, search, outcome, close,
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month download article/chapter 5-mm margin-free method full article pdf privacy choices/manage cookies multi-institute survey breast-conserving therapy breast conserving therapy invasive breast cancer cancer institute hospital breast conservation therapy positive resection margin breast conserving surgery breast-conserving surgery tumor margin assessment schmidt-ullrich rk breast conserving irradiation breast conserving treatment breast care unit shikoku cancer center aichi cancer center twenty-year follow ii breast cancer 10-year ibtc rate related subjects treatment-related factors radiation dose effect close resection margins optimal conservation surgery 5-mm interval slices 10-year ibtc rates van den bogaert ics convention design breast cancer groups radiation dose equal adjuvant systemic therapy pathologic margin involvement radiation oncology breast cancer patients conditions privacy policy european economic area kaplan meier method draw final conclusions long-term follow accepting optional cookies article karasawa schmidt-ullrich positive margins treated positive margins influences positive surgical margins positive margin patients
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headline:Treatment outcome of breast-conserving therapy in patients with positive or close resection margins: Japanese multi institute survey for radiation dose effect
description:The relationship between a positive resection margin and the risk of ipsilateral breast tumor recurrence (IBTR) is controversial. To evaluate the radiation dose and other factors influencing the ipsilateral breast tumor control (IBTC) in patients with positive or close resection margins after breast conserving surgery (BCS), the Japanese Radiation Oncology Study Group GROSG) S-99-3 study group conducted a multi-institute survey of these patients. The patients with less than 5 mm tumor-free margins after BCS were eligible for this study. A total of 971 patients from 18 institutes were enrolled in the analysis. The final pathological margin status was classified into 3 groups. Radiation doses to the tumor bed were less than 60 Gy in 252 patients, 60 Gy in 456 patients and more than 60 Gy in 233 patients. IBTR was observed in 55 patients (5.8%). The IBTC rates at 5 and 10 years by the Kaplan Meier method were 95.6% and 87.3%, respectively. There was no significant difference in 10-year IBTC rates according to marginal status; 85.9% in positive margin patients, 91.0% in equal or less than 2 mm margin patients and 87.0% in 2.1β5 mm margin patients. Radiation dose to the tumor bed was a marginally significantly associated with the 10-year IBTC rate (β₯60 Gy 90.8% vs <60 Gy 84.2%,p=0.057). In patients with positive margins, IBTC with radiation dose equal to or more than 60 Gy was significantly better (p= 0.039). The other factors influencing the IBTC were age (β₯35 years vs <35 years:p<0.0001), menopausal status (p<0.0001) and tumor size (p=0.023). In patients with positive margins, IBTC with radiation dose equal to or more than 60 Gy was significantly better than the others. We recommend that the tumor bed be irradiated with at least 60 Gy in the patients with positive margins. Further follow-up is necessary to draw final conclusions.
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Breast conserving therapy
Resection margin
Radiotherapy
Surgical Oncology
Oncology
Surgery
Cancer Research
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headline:Treatment outcome of breast-conserving therapy in patients with positive or close resection margins: Japanese multi institute survey for radiation dose effect
description:The relationship between a positive resection margin and the risk of ipsilateral breast tumor recurrence (IBTR) is controversial. To evaluate the radiation dose and other factors influencing the ipsilateral breast tumor control (IBTC) in patients with positive or close resection margins after breast conserving surgery (BCS), the Japanese Radiation Oncology Study Group GROSG) S-99-3 study group conducted a multi-institute survey of these patients. The patients with less than 5 mm tumor-free margins after BCS were eligible for this study. A total of 971 patients from 18 institutes were enrolled in the analysis. The final pathological margin status was classified into 3 groups. Radiation doses to the tumor bed were less than 60 Gy in 252 patients, 60 Gy in 456 patients and more than 60 Gy in 233 patients. IBTR was observed in 55 patients (5.8%). The IBTC rates at 5 and 10 years by the Kaplan Meier method were 95.6% and 87.3%, respectively. There was no significant difference in 10-year IBTC rates according to marginal status; 85.9% in positive margin patients, 91.0% in equal or less than 2 mm margin patients and 87.0% in 2.1β5 mm margin patients. Radiation dose to the tumor bed was a marginally significantly associated with the 10-year IBTC rate (β₯60 Gy 90.8% vs <60 Gy 84.2%,p=0.057). In patients with positive margins, IBTC with radiation dose equal to or more than 60 Gy was significantly better (p= 0.039). The other factors influencing the IBTC were age (β₯35 years vs <35 years:p<0.0001), menopausal status (p<0.0001) and tumor size (p=0.023). In patients with positive margins, IBTC with radiation dose equal to or more than 60 Gy was significantly better than the others. We recommend that the tumor bed be irradiated with at least 60 Gy in the patients with positive margins. Further follow-up is necessary to draw final conclusions.
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Breast conserving therapy
Resection margin
Radiotherapy
Surgical Oncology
Oncology
Surgery
Cancer Research
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