Audit of local recurrence following breast conservation surgery with 5-mm target margin and hypofractionated 40-Gray breast radiotherapy for invasive breast cancer
The risk of ipsilateral breast tumour recurrence (IBTR) following breast conservation surgery (BCS) for invasive breast cancer (IBC) and radiotherapy is dependent on patient-, tumour- and treatment-related variables. In the Cambridge Breast Unit, breast conserving surgery has been performed with a t...
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| Veröffentlicht in: | Annals of the Royal College of Surgeons of England 2010-10, Vol.92 (7), p.562-568 |
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| creator | Liau, Siong-Seng Cariati, Massimiliano Noble, David Wilson, Charles Wishart, Gordon C |
| description | The risk of ipsilateral breast tumour recurrence (IBTR) following breast conservation surgery (BCS) for invasive breast cancer (IBC) and radiotherapy is dependent on patient-, tumour- and treatment-related variables. In the Cambridge Breast Unit, breast conserving surgery has been performed with a target radial margin of 5 mm for IBC, in combination with 40-Gy hypofractionated (15 fractions) breast radiotherapy, since 1999.
An audit was performed of cases treated between 1999 and 2004. A total of 563 patients underwent BCS for invasive breast cancer with 90.4% receiving radiotherapy (RT) and 60.4% of patients receiving boost RT (3 fractions of 3-Gy).
After a median follow-up of 58 months, five of the 563 (0.9%) patients developed IBTR. The 5-year actuarial IBTR rate was 1.1%. In terms of distant disease recurrence (DDR), 29 of the 563 (5.2%) had DDR during follow-up, giving a 5-year actuarial DDR rate of 5.4%. The 5-year breast cancer specific survival was 95%, with the poorer NPI groups having worse breast cancer specific survival (Log-rank, P |
| doi_str_mv | 10.1308/003588410X12699663903476 |
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An audit was performed of cases treated between 1999 and 2004. A total of 563 patients underwent BCS for invasive breast cancer with 90.4% receiving radiotherapy (RT) and 60.4% of patients receiving boost RT (3 fractions of 3-Gy).
After a median follow-up of 58 months, five of the 563 (0.9%) patients developed IBTR. The 5-year actuarial IBTR rate was 1.1%. In terms of distant disease recurrence (DDR), 29 of the 563 (5.2%) had DDR during follow-up, giving a 5-year actuarial DDR rate of 5.4%. The 5-year breast cancer specific survival was 95%, with the poorer NPI groups having worse breast cancer specific survival (Log-rank, P<0.0001). More importantly, patients with IBTR had a shorter breast cancer-specific survival than those who were IBTR-free (Log-rank, P<0.0001).
Our treatment regimen, combining BCS with a 5-mm target margin and hypofractionated 40-Gy RT, results in an extremely low rate of IBTR, and compares favourably with the target IBTR rate of <5% defined by the Association of Breast Surgeons (ABS) at BASO guidelines.</description><identifier>ISSN: 0035-8843</identifier><identifier>EISSN: 1478-7083</identifier><identifier>DOI: 10.1308/003588410X12699663903476</identifier><identifier>PMID: 20522309</identifier><language>eng</language><publisher>England: BMJ Publishing Group LTD</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Audits ; Biopsy ; Breast cancer ; Breast Neoplasms - pathology ; Breast Neoplasms - radiotherapy ; Breast Neoplasms - surgery ; Breast Surgery ; Cancer therapies ; Chemotherapy ; Epidemiologic Methods ; Female ; Gene expression ; Humans ; Lymphatic system ; Mammography ; Mastectomy ; Mastectomy, Segmental - methods ; Mastectomy, Segmental - standards ; Middle Aged ; Neoplasm Invasiveness ; Neoplasm Recurrence, Local ; Patients ; Performance evaluation ; Prognosis ; Radiation therapy ; Radiotherapy, Adjuvant ; Surgeons ; Surgery ; Treatment Outcome ; Tumors ; Womens health</subject><ispartof>Annals of the Royal College of Surgeons of England, 2010-10, Vol.92 (7), p.562-568</ispartof><rights>Copyright Royal College of Surgeons of England Oct 2010</rights><rights>Copyright © 2010 by the Annals of The Royal College of Surgeons of England 2010</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c415t-79f33bc6ba2f3928e1e3c6781748cdf07b2f164c0089a2fdcf3a729be1727963</citedby><cites>FETCH-LOGICAL-c415t-79f33bc6ba2f3928e1e3c6781748cdf07b2f164c0089a2fdcf3a729be1727963</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3229345/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3229345/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,724,777,781,882,27905,27906,53772,53774</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20522309$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Liau, Siong-Seng</creatorcontrib><creatorcontrib>Cariati, Massimiliano</creatorcontrib><creatorcontrib>Noble, David</creatorcontrib><creatorcontrib>Wilson, Charles</creatorcontrib><creatorcontrib>Wishart, Gordon C</creatorcontrib><title>Audit of local recurrence following breast conservation surgery with 5-mm target margin and hypofractionated 40-Gray breast radiotherapy for invasive breast cancer</title><title>Annals of the Royal College of Surgeons of England</title><addtitle>Ann R Coll Surg Engl</addtitle><description>The risk of ipsilateral breast tumour recurrence (IBTR) following breast conservation surgery (BCS) for invasive breast cancer (IBC) and radiotherapy is dependent on patient-, tumour- and treatment-related variables. In the Cambridge Breast Unit, breast conserving surgery has been performed with a target radial margin of 5 mm for IBC, in combination with 40-Gy hypofractionated (15 fractions) breast radiotherapy, since 1999.
An audit was performed of cases treated between 1999 and 2004. A total of 563 patients underwent BCS for invasive breast cancer with 90.4% receiving radiotherapy (RT) and 60.4% of patients receiving boost RT (3 fractions of 3-Gy).
After a median follow-up of 58 months, five of the 563 (0.9%) patients developed IBTR. The 5-year actuarial IBTR rate was 1.1%. In terms of distant disease recurrence (DDR), 29 of the 563 (5.2%) had DDR during follow-up, giving a 5-year actuarial DDR rate of 5.4%. The 5-year breast cancer specific survival was 95%, with the poorer NPI groups having worse breast cancer specific survival (Log-rank, P<0.0001). More importantly, patients with IBTR had a shorter breast cancer-specific survival than those who were IBTR-free (Log-rank, P<0.0001).
Our treatment regimen, combining BCS with a 5-mm target margin and hypofractionated 40-Gy RT, results in an extremely low rate of IBTR, and compares favourably with the target IBTR rate of <5% defined by the Association of Breast Surgeons (ABS) at BASO guidelines.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Audits</subject><subject>Biopsy</subject><subject>Breast cancer</subject><subject>Breast Neoplasms - pathology</subject><subject>Breast Neoplasms - radiotherapy</subject><subject>Breast Neoplasms - surgery</subject><subject>Breast Surgery</subject><subject>Cancer therapies</subject><subject>Chemotherapy</subject><subject>Epidemiologic Methods</subject><subject>Female</subject><subject>Gene expression</subject><subject>Humans</subject><subject>Lymphatic system</subject><subject>Mammography</subject><subject>Mastectomy</subject><subject>Mastectomy, Segmental - methods</subject><subject>Mastectomy, Segmental - standards</subject><subject>Middle Aged</subject><subject>Neoplasm Invasiveness</subject><subject>Neoplasm Recurrence, Local</subject><subject>Patients</subject><subject>Performance evaluation</subject><subject>Prognosis</subject><subject>Radiation therapy</subject><subject>Radiotherapy, Adjuvant</subject><subject>Surgeons</subject><subject>Surgery</subject><subject>Treatment Outcome</subject><subject>Tumors</subject><subject>Womens health</subject><issn>0035-8843</issn><issn>1478-7083</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1UcuKFDEUDaI47egvSMB1aR5VeWyEYdBRGHAzC3chlUq6M1Qn7U2qh_oef9Q0M9PowtWFe8_rchDClHyknKhPhPBBqZ6Sn5QJrYXgmvBeihdoQ3upOkkUf4k2J1jXcPwCvSnlnhCqpaKv0QUjA2Oc6A36fbVMseIc8JydnTF4twD45DwOeZ7zQ0xbPIK3pWKXU_FwtDXmhMsCWw8rfoh1h4duv8fVtk3F-zZiwjZNeLcecgDrTgRb_YR70t2AXZ8FwU4x150He1ibHeCYjrbEoz872hYE3qJXwc7Fv3ual-ju65e762_d7Y-b79dXt53r6VA7qQPnoxOjZYFrpjz13In2sOyVmwKRIwtU9I4QpRtkcoFbyfToqWRSC36JPj_KHpZx7yfnUwU7mwPE9tJqso3m30uKO7PNR8MZ07wfmsCHJwHIvxZfqrnPC6QW2TBGpJJKMN5Q6hHlIJcCPpwdKDGnds3_2m3U938nPBOf6-R_AH3DpQ4</recordid><startdate>20101001</startdate><enddate>20101001</enddate><creator>Liau, Siong-Seng</creator><creator>Cariati, Massimiliano</creator><creator>Noble, David</creator><creator>Wilson, Charles</creator><creator>Wishart, Gordon C</creator><general>BMJ Publishing Group LTD</general><general>The Royal College of Surgeons of England</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>EHMNL</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>5PM</scope></search><sort><creationdate>20101001</creationdate><title>Audit of local recurrence following breast conservation surgery with 5-mm target margin and hypofractionated 40-Gray breast radiotherapy for invasive breast cancer</title><author>Liau, Siong-Seng ; Cariati, Massimiliano ; Noble, David ; Wilson, Charles ; Wishart, Gordon C</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c415t-79f33bc6ba2f3928e1e3c6781748cdf07b2f164c0089a2fdcf3a729be1727963</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Audits</topic><topic>Biopsy</topic><topic>Breast cancer</topic><topic>Breast Neoplasms - pathology</topic><topic>Breast Neoplasms - radiotherapy</topic><topic>Breast Neoplasms - surgery</topic><topic>Breast Surgery</topic><topic>Cancer therapies</topic><topic>Chemotherapy</topic><topic>Epidemiologic Methods</topic><topic>Female</topic><topic>Gene expression</topic><topic>Humans</topic><topic>Lymphatic system</topic><topic>Mammography</topic><topic>Mastectomy</topic><topic>Mastectomy, Segmental - methods</topic><topic>Mastectomy, Segmental - standards</topic><topic>Middle Aged</topic><topic>Neoplasm Invasiveness</topic><topic>Neoplasm Recurrence, Local</topic><topic>Patients</topic><topic>Performance evaluation</topic><topic>Prognosis</topic><topic>Radiation therapy</topic><topic>Radiotherapy, Adjuvant</topic><topic>Surgeons</topic><topic>Surgery</topic><topic>Treatment Outcome</topic><topic>Tumors</topic><topic>Womens health</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Liau, Siong-Seng</creatorcontrib><creatorcontrib>Cariati, Massimiliano</creatorcontrib><creatorcontrib>Noble, David</creatorcontrib><creatorcontrib>Wilson, Charles</creatorcontrib><creatorcontrib>Wishart, Gordon C</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>UK & Ireland Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Annals of the Royal College of Surgeons of England</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Liau, Siong-Seng</au><au>Cariati, Massimiliano</au><au>Noble, David</au><au>Wilson, Charles</au><au>Wishart, Gordon C</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Audit of local recurrence following breast conservation surgery with 5-mm target margin and hypofractionated 40-Gray breast radiotherapy for invasive breast cancer</atitle><jtitle>Annals of the Royal College of Surgeons of England</jtitle><addtitle>Ann R Coll Surg Engl</addtitle><date>2010-10-01</date><risdate>2010</risdate><volume>92</volume><issue>7</issue><spage>562</spage><epage>568</epage><pages>562-568</pages><issn>0035-8843</issn><eissn>1478-7083</eissn><abstract>The risk of ipsilateral breast tumour recurrence (IBTR) following breast conservation surgery (BCS) for invasive breast cancer (IBC) and radiotherapy is dependent on patient-, tumour- and treatment-related variables. In the Cambridge Breast Unit, breast conserving surgery has been performed with a target radial margin of 5 mm for IBC, in combination with 40-Gy hypofractionated (15 fractions) breast radiotherapy, since 1999.
An audit was performed of cases treated between 1999 and 2004. A total of 563 patients underwent BCS for invasive breast cancer with 90.4% receiving radiotherapy (RT) and 60.4% of patients receiving boost RT (3 fractions of 3-Gy).
After a median follow-up of 58 months, five of the 563 (0.9%) patients developed IBTR. The 5-year actuarial IBTR rate was 1.1%. In terms of distant disease recurrence (DDR), 29 of the 563 (5.2%) had DDR during follow-up, giving a 5-year actuarial DDR rate of 5.4%. The 5-year breast cancer specific survival was 95%, with the poorer NPI groups having worse breast cancer specific survival (Log-rank, P<0.0001). More importantly, patients with IBTR had a shorter breast cancer-specific survival than those who were IBTR-free (Log-rank, P<0.0001).
Our treatment regimen, combining BCS with a 5-mm target margin and hypofractionated 40-Gy RT, results in an extremely low rate of IBTR, and compares favourably with the target IBTR rate of <5% defined by the Association of Breast Surgeons (ABS) at BASO guidelines.</abstract><cop>England</cop><pub>BMJ Publishing Group LTD</pub><pmid>20522309</pmid><doi>10.1308/003588410X12699663903476</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Aged Aged, 80 and over Audits Biopsy Breast cancer Breast Neoplasms - pathology Breast Neoplasms - radiotherapy Breast Neoplasms - surgery Breast Surgery Cancer therapies Chemotherapy Epidemiologic Methods Female Gene expression Humans Lymphatic system Mammography Mastectomy Mastectomy, Segmental - methods Mastectomy, Segmental - standards Middle Aged Neoplasm Invasiveness Neoplasm Recurrence, Local Patients Performance evaluation Prognosis Radiation therapy Radiotherapy, Adjuvant Surgeons Surgery Treatment Outcome Tumors Womens health |
| title | Audit of local recurrence following breast conservation surgery with 5-mm target margin and hypofractionated 40-Gray breast radiotherapy for invasive breast cancer |
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