Radiation Therapy in Older Patients After Breast Conserving Surgery

Rodrigo Arrangoiz MS, MD, FACS, FSSO
  • Increasing data are available evaluating the role of adjuvant radiation therapy in older patients undergoing breast-conserving surgery with small, ER positive tumors
  • CALGB 9343 trial:
    • Enrolled 636 women over the age of 70 with T1, N0, ER positive tumors
    • Randomizing patients to adjuvant endocrine therapy (tamoxifen) with or without radiation therapy
    • At 12 years, the risk of local-regional recurrence was 9% without radiation and 2% with radiation, confirming the initial 5-year results
    • No differences in breast cancer-specific survival or overall survival were noted
  • More recently, results from the PRIME II trial were published:
    • The trial enrolled 1,326 patients 65 years or older with T1 to T2 (< 3 cm), node negative tumors and clear margins
    • Following breast-conserving surgery, patients received endocrine therapy, and were randomized to adjuvant radiation therapy or no further treatment
    • At 5 years, those undergoing radiation demonstrated a reduction in local recurrence (4.1% vs. 1.3%) with no difference in survival noted
  • References
    • Hughes KS, Schnaper LA, Bellon JR, et al. Lumpectomy plus tamoxifen with or without irradiation in women age 70 years or older with early breast cancer: long-term follow-up of CALGB 9343. J Clin Oncol. 2013;31(19):2382-2387.
    • Kunkler IH, William LJ, Jack WJ, et al. Breast-conserving surgery with or without irradiation in women aged 65 years or older with early breast cancer (PRIME II): a randomised controlled trial. Lancet Oncol. 2015;16(3):266-273.
Unknown's avatar

Published by Rodrigo Arrangoiz MS, MD, FACS, FSSO

My name is Rodrigo Arrangoiz I am a breast surgeon/ thyroid surgeon / parathyroid surgeon / head and neck surgeon / surgical oncologist that works at Center for Advanced Surgical Oncology in Miami, Florida. I was trained as a surgeon at Michigan State University from (2005 to 2010) where I was a chief resident in 2010. My surgical oncology and head and neck training was performed at the Fox Chase Cancer Center in Philadelphia from 2010 to 2012. At the same time I underwent a masters in science (Clinical research for health professionals) at the University of Drexel. Through the International Federation of Head and Neck Societies / Memorial Sloan Kettering Cancer Center I performed a two year head and neck surgery and oncology / endocrine fellowship that ended in 2016. Mi nombre es Rodrigo Arrangoiz, soy cirujano oncólogo / cirujano de tumores de cabeza y cuello / cirujano endocrino que trabaja Center for Advanced Surgical Oncology en Miami, Florida. Fui entrenado como cirujano en Michigan State University (2005 a 2010 ) donde fui jefe de residentes en 2010. Mi formación en oncología quirúrgica y e n tumores de cabeza y cuello se realizó en el Fox Chase Cancer Center en Filadelfia de 2010 a 2012. Al mismo tiempo, me sometí a una maestría en ciencias (investigación clínica para profesionales de la salud) en la Universidad de Drexel. A través de la Federación Internacional de Sociedades de Cabeza y Cuello / Memorial Sloan Kettering Cancer Center realicé una sub especialidad en cirugía de cabeza y cuello / cirugia endocrina de dos años que terminó en 2016.

Leave a comment