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Omitting adjuvant radiotherapy for hormone receptor-positive early-stage breast cancer in old age: A propensity score matched SEER analysis

Title
Omitting adjuvant radiotherapy for hormone receptor-positive early-stage breast cancer in old age: A propensity score matched SEER analysis
Authors
Kim Y.-J.Shin K.H.Kim K.
Ewha Authors
김경효
SCOPUS Author ID
김경효scopus
Issue Date
2019
Journal Title
Cancer Research and Treatment
ISSN
1598-2998JCR Link
Citation
Cancer Research and Treatment vol. 51, no. 1, pp. 326 - 336
Keywords
Adjuvant radiotherapyAgedBreast neoplasmsEstrogen receptorsProgesterone receptorsSEER databaseTumor gradeTumor size
Publisher
Korean Cancer Association
Indexed
SCIE; SCOPUS; KCI WOS scopus
Document Type
Article
Abstract
Purpose: The purpose of this study was to investigate the non-inferiority of omitting radiotherapy (RT) after breast-conserving surgery (BCS) for hormone receptor (HR)-positive T1N0 breast cancer in elderly women. Materials and Methods: From 2004 to 2014, HR-positive T1N0 breast cancer patients aged 50 years or older and receiving BCS were retrieved from the Surveillance, Epidemiology, and End Results 18 database. After propensity score matching between the no-RT and RT groups, univariate and multivariate analyses were performed. Identified prognostic factors were used to stratify the risk groups. In each risk group, 10-year cancer-specific survival (CSS) rates were compared between the no-RT and RT groups. Results: After propensity score matching, the numbers of patients in the no-RT and RT groups were both 18,586. For patients who satisfied both a tumor size of 1-10 mm and a tumor grade of 1-2, omitting RT did not decrease the CSS rate at any age group, ranging from ≥ 50 to ≥ 85 years; for patients aged ≥ 50 years, the 10-year CSS rates in the no-RT and RT groups were 97.2% and 96.8%, respectively (adjusted hazard ratio, 0.862; p=0.312). However, for patients with a tumor size of 11-20 mm or tumor grade of 3-4, RT significantly increased the CSS rate irrespective of age. Conclusion RT after BCS for HR-positive T1N0 breast cancer in elderly women might be omitted without causing a decrease in the CSS rate, but only in patients who satisfy both a small tumor size (≤ 10 mm) and low tumor grade (1-2). Copyright © 2019 by the Korean Cancer Association
DOI
10.4143/crt.2018.163
Appears in Collections:
의과대학 > 의학과 > Journal papers
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