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Improving local control with breast-conserving therapy: a 27-year single-institution experience
Neslihan Cabioglu1, Kelly K Hunt, Thomas A Buchholz
1Department of Surgical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030, USA.
Cancer
|May 25, 2005
Summary
Breast-conserving therapy (BCT) shows declining rates of ipsilateral breast tumor recurrence (IBTR), particularly in younger patients. This improvement is linked to advancements in surgical techniques and increased use of systemic therapies.
Area of Science:
- Oncology
- Surgical Oncology
- Breast Cancer Research
Background:
- Ipsilateral breast tumor recurrence (IBTR) risk after breast-conserving therapy (BCT) is influenced by treatment and tumor factors.
- These factors, including surgical margin status and systemic therapy use, have evolved over time.
Purpose of the Study:
- To test the hypothesis that contemporary multidisciplinary management of breast carcinoma improves IBTR rates after BCT.
- To compare IBTR rates and patient/tumor characteristics between two treatment periods.
Main Methods:
- Retrospective analysis of 1355 patients with Stage I-II invasive breast carcinoma treated with BCT between 1970-1996.
- Comparison of IBTR rates and characteristics for patients treated during 1994-1996 versus 1970-1993.
- Multivariate analysis to identify predictors of IBTR-free survival.
Main Results:
- The 1994-1996 cohort showed significantly lower 5-year IBTR rates (1.3% vs. 5.7%) compared to the 1970-1993 cohort, especially in patients under 50.
- Patients treated after 1994 had improved margin status, increased chemotherapy and hormonal therapy use, and decreased radiation boosts.
- Age >50, negative surgical margins, and adjuvant hormonal therapy were independent predictors of improved IBTR-free survival.
Conclusions:
- The IBTR rate after BCT is declining, with a notable decrease in patients under 50.
- This trend may be attributed to improved surgical approaches, pathological evaluation, and increased systemic therapy use.
- The reduced IBTR incidence may encourage more patients to opt for BCT over mastectomy.