Survival and toxicity after breast-conserving surgery and external beam reirradiation for localized ipsilateral breast tumour recurrence: A population-based study.
Cancer Radiother
; 28(3): 265-271, 2024 Jun.
Article
in En
| MEDLINE
| ID: mdl-38897883
ABSTRACT
PURPOSE:
Breast-conserving surgery followed by reirradiation for a localized ipsilateral breast tumour relapse may increase the radiation dose delivered to the heart and result in a greater risk of cardiac adverse events. This study aimed to compare the incidence of cardiac mortality in patients treated for a localized ipsilateral breast tumour relapse, either with breast-conserving surgery followed by reirradiation or with total mastectomy between 2000 and 2020. MATERIALS ANDMETHODS:
All patients treated for a primary non-metastatic breast cancer with breast-conserving surgery and adjuvant radiotherapy were identified in the Surveillance, Epidemiology, and End Results (SEER) program database, and those who subsequently experienced a localized ipsilateral breast tumour relapse treated with breast-conserving surgery and reirradiation ("BCS+ReRT" group, n=239) or with total mastectomy ("TM" group, n=3127) were included. The primary objective was to compare the cardiac mortality rate between the patients who underwent breast-conserving surgery followed by reirradiation and total mastectomy. Secondary endpoints were overall survival and cancer specific survival.RESULTS:
Cardiac mortality was significantly higher in patients treated with breast-conserving surgery followed by reirradiation (hazard ratio [HR] 2.40, 95% confidence interval [95% CI] 1.19-4.86, P=0.006) in univariate analysis; non-statistically significant differences were observed after adjusting for age, laterality and chemotherapy on multivariate analysis (HR 1.96, 95% CI 0.96-3.94, P=0.067), age being the only confounding factor. A non-statistically significant difference towards lower overall survival was observed in patients who had breast-conserving surgery followed by reirradiation compared with those who underwent total mastectomy (HR 1.37, 95% CI 0.98-1.90, P=0.066), and no differences were observed in terms of cancer specific survival (HR 1.01, 95% CI 0.56-1.82, P=0.965).CONCLUSION:
In this study, the incidence of cardiac mortality was low, and breast-conserving surgery followed by reirradiation did not independently increased the risk of cardiac mortality for a localized ipsilateral breast tumour relapse.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Mastectomy, Segmental
/
Re-Irradiation
/
Neoplasm Recurrence, Local
Limits:
Adult
/
Aged
/
Female
/
Humans
/
Middle aged
Language:
En
Journal:
Cancer Radiother
Journal subject:
NEOPLASIAS
/
RADIOTERAPIA
Year:
2024
Document type:
Article
Affiliation country:
Francia