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Published on: June 7, 2015
Ipsilateral breast tumour recurrence (IBTR) dynamics in breast conserving treatments with or without radiotherapy
Romano Demicheli1, Ilaria Ardoino, Patrizia Boracchi
1Department of Medical Oncology, Università di Milano, Milano, Italy. demicheli@istitutotumori.mi.it
Purpose:
To study whether ipsilateral breast tumour recurrence (IBTR) dynamics are modified by post-operative radiotherapy (RT).
Methods And Materials:
The hazard rate for IBTR was analysed in a database from patients undergoing breast conserving surgery with or without post-operative radiotherapy within randomised clinical trials from the Milan Cancer Institute.
Results:
The hazard rate for IBTR presents a bimodal pattern. Post-operative radiotherapy, in addition to reducing IBTR incidence from 24.5% to 5.8% at 10 years, causes more than a one year delay in its clinical manifestation. Distant metastasis dynamics are not modified by radiotherapy administration.
Conclusions:
In the light of a biology-based model of breast cancer metastasis development, IBTR peak delay most likely originates in a more prolonged dormancy time that, in turn, is related to local microenvironment conditions. Present clinical findings suggest that, besides a direct killing effect on residual tumour cells, microenvironmental modifications may play a major role in RT effectiveness.
