Local Recurrence After Breast-Conserving Therapy in Patients With Multiple Ipsilateral Breast Cancer: Results From ACOSOG Z11102 (Alliance)

Breast-conserving therapy (BCT) is the preferred treatment for unifocal breast cancer (BC). The oncologic safety of BCT for multiple ipsilateral breast cancer (MIBC) has not been demonstrated in a prospective study. ACOSOG Z11102 (Alliance) is a phase II, single-arm, prospective trial designed to ev...

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Veröffentlicht in:Journal of clinical oncology 2023-06, Vol.41 (17), p.3184-3193
Hauptverfasser: Boughey, Judy C, Rosenkranz, Kari M, Ballman, Karla V, McCall, Linda, Haffty, Bruce G, Cuttino, Laurie W, Kubicky, Charlotte D, Le-Petross, Huong T, Giuliano, Armando E, Van Zee, Kimberly J, Hunt, Kelly K, Hahn, Olwen M, Carey, Lisa A, Partridge, Ann H
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container_end_page 3193
container_issue 17
container_start_page 3184
container_title Journal of clinical oncology
container_volume 41
creator Boughey, Judy C
Rosenkranz, Kari M
Ballman, Karla V
McCall, Linda
Haffty, Bruce G
Cuttino, Laurie W
Kubicky, Charlotte D
Le-Petross, Huong T
Giuliano, Armando E
Van Zee, Kimberly J
Hunt, Kelly K
Hahn, Olwen M
Carey, Lisa A
Partridge, Ann H
description Breast-conserving therapy (BCT) is the preferred treatment for unifocal breast cancer (BC). The oncologic safety of BCT for multiple ipsilateral breast cancer (MIBC) has not been demonstrated in a prospective study. ACOSOG Z11102 (Alliance) is a phase II, single-arm, prospective trial designed to evaluate oncologic outcomes in patients undergoing BCT for MIBC. Women age 40 years and older with two to three foci of biopsy-proven cN0-1 BC were eligible. Patients underwent lumpectomies with negative margins followed by whole breast radiation with boost to all lumpectomy beds. The primary end point was cumulative incidence of local recurrence (LR) at 5 years with an a priori rate of clinical acceptability of
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The oncologic safety of BCT for multiple ipsilateral breast cancer (MIBC) has not been demonstrated in a prospective study. ACOSOG Z11102 (Alliance) is a phase II, single-arm, prospective trial designed to evaluate oncologic outcomes in patients undergoing BCT for MIBC. Women age 40 years and older with two to three foci of biopsy-proven cN0-1 BC were eligible. Patients underwent lumpectomies with negative margins followed by whole breast radiation with boost to all lumpectomy beds. The primary end point was cumulative incidence of local recurrence (LR) at 5 years with an a priori rate of clinical acceptability of &lt;8%. Among 270 women enrolled between November 2012 and August 2016, there were 204 eligible patients who underwent protocol-directed BCT. The median age was 61 years (range, 40-87 years). At a median follow-up of 66.4 months (range, 1.3-90.6 months), six patients developed LR for an estimated 5-year cumulative incidence of LR of 3.1% (95% CI, 1.3 to 6.4). Patient age, number of sites of preoperative biopsy-proven BC, estrogen receptor status and human epidermal growth factor receptor 2 status, and pathologic T and N categories were not associated with LR risk. Exploratory analysis showed that the 5-year LR rate in patients without preoperative magnetic resonance imaging (MRI; n = 15) was 22.6% compared with 1.7% in patients with a preoperative MRI (n = 189; = .002). The Z11102 clinical trial demonstrates that breast-conserving surgery with adjuvant radiation that includes lumpectomy site boosts yields an acceptably low 5-year LR rate for MIBC. This evidence supports BCT as a reasonable surgical option for women with two to three ipsilateral foci, particularly among patients with disease evaluated with preoperative breast MRI.</description><identifier>ISSN: 0732-183X</identifier><identifier>EISSN: 1527-7755</identifier><identifier>DOI: 10.1200/JCO.22.02553</identifier><identifier>PMID: 36977292</identifier><language>eng</language><publisher>United States: Wolters Kluwer Health</publisher><subject>Adult ; Breast - pathology ; Breast Neoplasms - pathology ; Female ; Humans ; Mastectomy, Segmental - adverse effects ; Middle Aged ; Neoplasm Recurrence, Local - epidemiology ; Neoplasm Recurrence, Local - pathology ; ORIGINAL REPORTS ; Prospective Studies ; Radiotherapy, Adjuvant</subject><ispartof>Journal of clinical oncology, 2023-06, Vol.41 (17), p.3184-3193</ispartof><rights>2023 by American Society of Clinical Oncology 2023 American Society of Clinical Oncology</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c347t-167707611f8e479578bf3826da9d4c3c938a9f745d11ed84b017408d1f88556f3</citedby><cites>FETCH-LOGICAL-c347t-167707611f8e479578bf3826da9d4c3c938a9f745d11ed84b017408d1f88556f3</cites><orcidid>0000-0002-9597-6019 ; 0000-0003-3820-3228 ; 0000-0003-2388-4649 ; 0000-0002-4722-4824 ; 0000-0001-9156-8723</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,3716,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36977292$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Boughey, Judy C</creatorcontrib><creatorcontrib>Rosenkranz, Kari M</creatorcontrib><creatorcontrib>Ballman, Karla V</creatorcontrib><creatorcontrib>McCall, Linda</creatorcontrib><creatorcontrib>Haffty, Bruce G</creatorcontrib><creatorcontrib>Cuttino, Laurie W</creatorcontrib><creatorcontrib>Kubicky, Charlotte D</creatorcontrib><creatorcontrib>Le-Petross, Huong T</creatorcontrib><creatorcontrib>Giuliano, Armando E</creatorcontrib><creatorcontrib>Van Zee, Kimberly J</creatorcontrib><creatorcontrib>Hunt, Kelly K</creatorcontrib><creatorcontrib>Hahn, Olwen M</creatorcontrib><creatorcontrib>Carey, Lisa A</creatorcontrib><creatorcontrib>Partridge, Ann H</creatorcontrib><title>Local Recurrence After Breast-Conserving Therapy in Patients With Multiple Ipsilateral Breast Cancer: Results From ACOSOG Z11102 (Alliance)</title><title>Journal of clinical oncology</title><addtitle>J Clin Oncol</addtitle><description>Breast-conserving therapy (BCT) is the preferred treatment for unifocal breast cancer (BC). 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Patient age, number of sites of preoperative biopsy-proven BC, estrogen receptor status and human epidermal growth factor receptor 2 status, and pathologic T and N categories were not associated with LR risk. Exploratory analysis showed that the 5-year LR rate in patients without preoperative magnetic resonance imaging (MRI; n = 15) was 22.6% compared with 1.7% in patients with a preoperative MRI (n = 189; = .002). The Z11102 clinical trial demonstrates that breast-conserving surgery with adjuvant radiation that includes lumpectomy site boosts yields an acceptably low 5-year LR rate for MIBC. 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Patient age, number of sites of preoperative biopsy-proven BC, estrogen receptor status and human epidermal growth factor receptor 2 status, and pathologic T and N categories were not associated with LR risk. Exploratory analysis showed that the 5-year LR rate in patients without preoperative magnetic resonance imaging (MRI; n = 15) was 22.6% compared with 1.7% in patients with a preoperative MRI (n = 189; = .002). The Z11102 clinical trial demonstrates that breast-conserving surgery with adjuvant radiation that includes lumpectomy site boosts yields an acceptably low 5-year LR rate for MIBC. 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subjects Adult
Breast - pathology
Breast Neoplasms - pathology
Female
Humans
Mastectomy, Segmental - adverse effects
Middle Aged
Neoplasm Recurrence, Local - epidemiology
Neoplasm Recurrence, Local - pathology
ORIGINAL REPORTS
Prospective Studies
Radiotherapy, Adjuvant
title Local Recurrence After Breast-Conserving Therapy in Patients With Multiple Ipsilateral Breast Cancer: Results From ACOSOG Z11102 (Alliance)
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