Abstract
The effect of postoperative radiotherapy after sector resection for stage I-II lymph
node-negative breast cancer was evaluated in a patient population with access to public
mammographical screening. 1187 women were randomised to no further treatment or postoperative
radiotherapy following a standardised sector resection and axillary dissection. Radiation
was administered to a dose of 48-54 Gy. Median age was 60 years, and median size of
the detected tumours was 12 mm. Of the women 65% had their tumours detected by mammographical
screening. The relative risk (RR) of ipsilateral breast recurrence was significantly
higher in the non-irradiated patients compared with the irradiated patients, RR=3.33
(95% Confidence Interval (CI) 2.13–5.19, P<0.001). The corresponding cumulative incidence at 5 years was 14% versus 4%, respectively.
Overall survival (OS) was similar, RR=1.16 (95% CI 0.81–1.65, P=0.41), with 5 year probabilities of 93 and 94%, respectively. Recurrence-free survival
(RFS) at 5 years was significantly lower in the non-irradiated women, 77% versus 88%
(P<0.001). Although women above 49 years of age, whose tumours were detected with mammographical
screening, had the lowest rate of ipsilateral breast recurrence in this study, the
cumulative incidence of such event amounted to 10% at 5 years if radiotherapy was
not given. Such a recurrence rate has been considered as unacceptably high, but is,
however, in the same range as that reported after lumpectomy and postoperative radiotherapy
in published series.
Keywords
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Article info
Publication history
Accepted:
December 12,
2002
Received:
December 2,
2002
Identification
Copyright
© 2003 Published by Elsevier Inc.
