Role of radiotherapy in women over the age of 65 after breast conserving surgery for breast cancer: A 5-year retrospective study

Article type: Research Article

Authors: Clement, Zackariah^a; | McLeay, William^a | Hoffmann, Clive^a | Shin, Peter^a | Kiu, Andrew^a | Eaton, Michael^b

Affiliations: [a] Flinders Medical Centre, Adelaide, SA, Australia | [b] Department of Surgery, Flinders University School of Medicine, Adelaide, SA, Australia

Correspondence: [*] Corresponding author: Zackariah Clement, MBBS, FRACS. E-mail: [email protected]

Abstract: BACKGROUND/OBJECTIVE:This study aimed to analyse the local recurrence (LR) and breast cancer related mortality (BCRM) in older women who underwent breast-conserving surgery (BCS) with and without adjuvant radiotherapy (XRT). METHODS:This retrospective study included a total of 299 women who underwent BCS for early breast carcinoma, between the years of 2007 and 2011. Predictive risk factors, local recurrence (LR) and breast cancer related mortality (BCRM) were assessed with a mean follow-up period of 84 months. RESULTS:Women over the age of 65 in the XRT and No-XRT groups showed similar incidence of LR (5.8% vs 5%, p = 0.838). Women over 65 years old with XRT had a higher rate of BCRM (5.8% vs 0%, p = 0.05). Resection margins >5 mm had a lower rate of BCRM (HR 0.395, p = 0.05). Women under the age of 65, invasive ductal carcinoma, grade-3 tumours, HER-2 positive, triple negative, lympho-vascular invasion, axillary lymph node positivity, high breast density on mammography were associated with increased risk of LR and BCRM. CONCLUSIONS:XRT in women over the age of 65 did not decrease the risk of LR. Adjuvant XRT in older women should be offered to selective patients with high risk patient and tumour factors.

Keywords: Breast cancer, breast conserving surgery, older women, radiotherapy, recurrence, mortality

DOI: 10.3233/BD-180340

Journal: Breast Disease, vol. 37, no. 4, pp. 197-205, 2018