Skip to main content

Advertisement

SpringerLink
Log in

Long-term results after 12-year follow-up of patients treated with whole-breast and boost irradiation after breast-conserving surgery

  • Original Article
  • Published:
Japanese Journal of Radiology Aims and scope Submit manuscript

Abstract

Purpose

The long-term outcomes of whole-breast and boost irradiation after breast-conserving surgery (BCS) for patients with breast cancer were retrospectively analyzed.

Materials and methods

Patients who received whole-breast and boost irradiation after BCS from 1990 to 2002 were included. Boost irradiation was administered to each tumor bed, regardless of the surgical margin status. The median doses of whole-breast and boost irradiation were 45 Gy in 25 fractions (range 36–45 Gy), and 14 Gy in 7 fractions (range 0–14 Gy), respectively.

Results

Data for 306 patients were analyzed. With a median follow-up time of 144 months, the 10-year overall survival, disease-free survival, ipsilateral breast tumor recurrence (IBTR), and metachronous contralateral breast cancer (MCBC) occurrence rates were 93.0, 84.1, 2.1, and 4.1 %, respectively. In the multivariate analysis, pT2 was a significant risk factor for IBTR (p = 0.041), while age ≤ 50 years and pT2 were significant risk factors for MCBC occurrence (p = 0.003 and 0.043, respectively). One patient (0.3 %) developed angiosarcoma in the irradiated region 120 months after the completion of radiation therapy.

Conclusion

The 12-year outcome of breast-conserving therapy using whole-breast and boost irradiation with doses of 45 and 14 Gy, respectively, was favorable.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Darby S, McGale P, Correa C, Taylor C, Arriagada R, Clarke M, et al. Effect of radiotherapy after breast-conserving surgery on 10-year recurrence and 15-year breast cancer death: meta-analysis of individual patient data for 10,801 women in 17 randomised trials. Lancet. 2011;378:1707–16.

    Article  CAS  PubMed  Google Scholar 

  2. Bartelink H, Maingon P, Poortmans P, Weltens C, Fourquet A, Jager J, et al. Whole-breast irradiation with or without a boost for patients treated with breast-conserving surgery for early breast cancer: 20-year follow-up of a randomised phase 3 trial. Lancet Oncol. 2015;16:47–56.

    Article  PubMed  Google Scholar 

  3. Kim R, Nishimoto N, Osaki A, Kojima J, Fujii S, Inai K, et al. An analysis of relapsed breast cancer in patients previously treated with breast conserving surgery. Breast Cancer. 2001;8:146–52.

    Article  CAS  PubMed  Google Scholar 

  4. Lövey K, Fodor J, Major T, Szabó E, Orosz Z, Sulyok Z, et al. Fat necrosis after partial-breast irradiation with brachytherapy or electron irradiation versus standard whole-breast radiotherapy–4-year results of a randomized trial. Int J Radiat Oncol Biol Phys. 2007;69:724–31.

    Article  PubMed  Google Scholar 

  5. Santiago RJ, Wu L, Harris E, Fox K, Schultz D, Glick J, et al. Fifteen-year results of breast-conserving surgery and definitive irradiation for stage I and II breast carcinoma: the University of Pennsylvania experience. Int J Radiat Oncol Biol Phys. 2004;58:233–40.

    Article  PubMed  Google Scholar 

  6. Bellon JR, Come SE, Gelman RS, Henderson IC, Shulman LN, Silver BJ, et al. Sequencing of chemotherapy and radiation therapy in early-stage breast cancer: updated results of a prospective randomized trial. J Clin Oncol. 2005;23:1934–40.

    Article  PubMed  Google Scholar 

  7. Kreike B, Hart AA, van de Velde T, Borger J, Peterse H, Rutgers E, et al. Continuing risk of ipsilateral breast relapse after breast-conserving therapy at long-term follow-up. Int J Radiat Oncol Biol Phys. 2008;71:1014–21.

    Article  PubMed  Google Scholar 

  8. Poortmans PM, Collette L, Horiot JC, Van den Bogaert WF, Fourquet A, Kuten A, et al. Impact of the boost dose of 10 Gy versus 26 Gy in patients with early stage breast cancer after a microscopically incomplete lumpectomy: 10-year results of the randomised EORTC boost trial. Radiother Oncol. 2009;90:80–5.

    Article  PubMed  Google Scholar 

  9. Hill-Kayser CE, Chacko D, Hwang WT, Vapiwala N, Solin LJ. Long-term clinical and cosmetic outcomes after breast conservation treatment for women with early-stage breast carcinoma according to the type of breast boost. Int J Radiat Oncol Biol Phys. 2011;79:1048–54.

    Article  PubMed  Google Scholar 

  10. Iqbal J, Ginsburg O, Rochon PA, Sun P, Narod SA. Differences in breast cancer stage at diagnosis and cancer-specific survival by race and ethnicity in the United States. JAMA. 2015;313:165–73.

    Article  CAS  PubMed  Google Scholar 

  11. Goyal S, Buchholz TA, Haffy BG. Breast cancer: early stage. In: Halperin EC, Wazer DE, Perez CA, Brady LW, editors. Principles and practice of radiation oncology. 6th ed. Philadelphia: Lippincott Williams & Wilkins; 2013. p. 1044–139.

    Google Scholar 

  12. van der Leij F, Elkhuizen PH, Bartelink H, van de Vijver MJ. Predictive factors for local recurrence in breast cancer. Semin Radiat Oncol. 2012;22:100–7.

    Article  PubMed  Google Scholar 

  13. Arvold ND, Taghian AG, Niemierko A, Abi Raad RF, Sreedhara M, Nguyen PL, et al. Age, breast cancer subtype approximation, and local recurrence after breast-conserving therapy. J Clin Oncol. 2011;29:3885–91.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Houssami N, Macaskill P, Marinovich ML, Morrow M. The association of surgical margins and local recurrence in women with early-stage invasive breast cancer treated with breast-conserving therapy: a meta-analysis. Ann Surg Oncol. 2014;21:717–30.

    Article  PubMed  Google Scholar 

  15. Jones HA, Antonini N, Hart AA, Peterse JL, Horiot JC, Collin F, et al. Impact of pathological characteristics on local relapse after breast-conserving therapy: a subgroup analysis of the EORTC boost versus no boost trial. J Clin Oncol. 2009;27:4939–47.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Hill-Kayser CE, Harris EE, Hwang WT, Solin LJ. Twenty-year incidence and patterns of contralateral breast cancer after breast conservation treatment with radiation. Int J Radiat Oncol Biol Phys. 2006;66:1313–9.

    Article  PubMed  Google Scholar 

  17. Vichapat V, Gillett C, Fentiman IS, Tutt A, Holmberg L, Lüchtenborg M. Risk factors for metachronous contralateral breast cancer suggest two aetiological pathways. Eur J Cancer. 2011;47:1919–27.

    Article  PubMed  Google Scholar 

  18. Vichapat V, Garmo H, Holmqvist M, Liljegren G, Wärnberg F, Lambe M, et al. Tumor stage affects risk and prognosis of contralateral breast cancer: results from a large Swedish-population-based study. J Clin Oncol. 2012;30:3478–85.

    Article  PubMed  Google Scholar 

  19. Nozaki M, Kagami Y, Mitsumori M, Hiraoka M. A multicenter investigation of late adverse events in Japanese women treated with breast-conserving surgery plus conventional fractionated whole-breast radiation therapy. Jpn J Clin Oncol. 2012;42:522–7.

    Article  PubMed  Google Scholar 

  20. Yap J, Chuba PJ, Thomas R, Aref A, Lucas D, Severson RK, et al. Sarcoma as a second malignancy after treatment for breast cancer. Int J Radiat Oncol Biol Phys. 2002;52:1231–7.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Radiation Oncology, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan

    Shigeo Takahashi, Yuji Murakami, Nobuki Imano, Yuko Kaneyasu, Yoshiko Doi, Masahiro Kenjo, Tomoki Kimura & Yasushi Nagata

  2. Department of Radiation Oncology, Kagawa University Hospital, 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa, 761-0793, Japan

    Shigeo Takahashi

  3. Department of Radiotherapy, National Hospital Organization Fukuyama Medical Center, Hiroshima, Japan

    Yuko Kaneyasu

  4. Department of Breast Surgery, Hiroshima University Hospital, Hiroshima, Japan

    Takayuki Kadoya, Tsuyoshi Kataoka & Morihito Okada

  5. Department of Surgical Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan

    Takayuki Kadoya & Morihito Okada

  6. Department of Anatomical Pathology, Hiroshima University Hospital, Hiroshima, Japan

    Koji Arihiro

Authors
  1. Shigeo Takahashi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yuji Murakami
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Nobuki Imano
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Yuko Kaneyasu
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Yoshiko Doi
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Masahiro Kenjo
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Tomoki Kimura
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Takayuki Kadoya
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Koji Arihiro
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Tsuyoshi Kataoka
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Morihito Okada
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Yasushi Nagata
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Shigeo Takahashi.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical statement

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki Declaration and its later amendments.

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Takahashi, S., Murakami, Y., Imano, N. et al. Long-term results after 12-year follow-up of patients treated with whole-breast and boost irradiation after breast-conserving surgery. Jpn J Radiol 34, 595–604 (2016). https://doi.org/10.1007/s11604-016-0562-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11604-016-0562-2

Keywords

Search

Navigation