Omission of Adjuvant Irradiation Following a Partial Mastectomy

👉Multiple groups have attempted to define a favorable subgroup of women: – In whom the omission of adjuvant irradiation following a partial mastectomy is reasonable

👉One study (CALGB 9343): Randomized women:

– Ages 70 years and older

– Clinical stage I (T1, N0, M0) disease

– To tamoxifen for 5 years versus tamoxifen plus whole-breast irradiation

– Patients with estrogen receptor-negative tumors were excluded

– Most tumors were 2 cm or less, and surgical margins were required to be negative (defined as the absence of tumor at the inked margin)

👉Adjuvant whole-breast irradiation: – Significantly reduced the risk of local or regional failure: From 10% to 2% at 10 years

👉There were no significant differences in: – Distant disease-free survival or overall survival between the groups

👉The PRIME II trial: – Enrolled 1326 patients. – Ages 65 years and older. – With T1 to T2, node negative tumors and clear margins

👉Following breast-conserving surgery: – Patients received endocrine therapy and were randomized to adjuvant radiation therapy or no further treatmento

👉At 5 years those undergoing radiation demonstrated a reduction in local recurrence: – 4.1% vs 1.3% with no difference in survival

#Arrangoiz #CancerSurgeon #BreastSurgeon #SurgicalOncology #CASO #CenterforAdvancedSurgicalOncology #PalmettoGeneralHospital

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