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Hypofractionation with no boost after breast conservation in early-stage breast cancer patients

Medical Oncology volume 33, Article number: 108 (2016) Cite this article

Abstract

The aim of this study was to evaluate local control, survival and toxicity profile of a consecutive cohort of early-stage breast cancer (EBC) patients treated with adjuvant hypofractionated radiotherapy (HF) with no boost delivered to the lumpectomy cavity, after breast-conserving surgery (BCS). Between 2005 and 2015, a total of 493 women affected with EBC were treated with HF (46 Gy/20 fractions or 40.05 Gy/15 fractions) to the whole breast without boost to tumor bed, because of age and/or favorable tumor characteristics. The primary endpoint was 5-year actuarial local control (LC); secondary endpoints included survival, toxicity profile and cosmesis. Median follow-up was 57 months (range 6–124). Actuarial 5-year overall, cancer-specific, disease-free survival and LC were 96.3, 98.9, 97.8 and 98.6 %, respectively. On multivariate analysis, tumor stage (T1 vs. T2) and hormonal status (positive vs. negative estrogen receptors) were significantly correlated with LC. Only 2 % of patients experienced ≥G3 acute skin toxicity. Late toxicity was mild with only 1 case of G3 fibrosis. Most of the patients (95 %) had good–excellent cosmetic results. HF to the whole breast with no boost delivered to the tumor bed is a safe and effective option for a population of low-risk breast cancer patients after BCS, with excellent 5-year LC, mild toxicity profile and promising cosmetic outcome. A subgroup of patients with larger tumors and/or with no estrogen receptor expression may potentially benefit from treatment intensification with a boost dose to the lumpectomy cavity.

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Author information

Affiliations

  1. Department of Oncology, Radiation Oncology, University of Turin School of Medicine, Via Genova 3, 10126, Turin, Italy

    Francesca Arcadipane, Pierfrancesco Franco, Chiara De Colle, Jacopo Di Muzio, Emanuela Pelle, Stefania Martini, Riccardo Ragona & Umberto Ricardi

  2. Department of Oncology, Radiation Oncology, AOU Città della Salute e della Scienza, Turin, Italy

    Nadia Rondi

  3. Department of General and Specialistic Surgery, Breast Surgery Unit, AOU Città della Salute e della Scienza, Turin, Italy

    Ada Ala

  4. Department of Oncology, Medical Oncology 2, AOU Città della Salute e della Scienza, Turin, Italy

    Mario Airoldi

  5. Department of Oncology, Breast Oncology Unit, AOU Città della Salute e della Scienza, Turin, Italy

    Michela Donadio

  6. Department of Gynecology and Obstetrics, Breast Unit, AOU Città della Salute e della Scienza, Turin, Italy

    Corrado De Sanctis

  7. Department of Medical Sciences, Pathology Unit, University of Torino, Turin, Italy

    Isabella Castellano

Authors
  1. Francesca Arcadipane
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  2. Pierfrancesco Franco
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  3. Chiara De Colle
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  4. Nadia Rondi
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  5. Jacopo Di Muzio
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  7. Stefania Martini
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  8. Ada Ala
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  9. Mario Airoldi
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  10. Michela Donadio
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  11. Corrado De Sanctis
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  12. Isabella Castellano
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  13. Riccardo Ragona
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  14. Umberto Ricardi
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Corresponding author

Correspondence to Pierfrancesco Franco.

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Conflict of interest

All authors declare that they have no conflict of interest.

Ethical standards

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

Informed consent

Informed consent was obtained from all individual participants included in the study.

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The present study has been reviewed and approved by the Research Committee of our institution.

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Arcadipane, F., Franco, P., De Colle, C. et al. Hypofractionation with no boost after breast conservation in early-stage breast cancer patients. Med Oncol 33, 108 (2016). https://doi.org/10.1007/s12032-016-0821-1

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  • DOI: https://doi.org/10.1007/s12032-016-0821-1

Keywords

  • Breast cancer
  • Hypofractionated radiotherapy
  • Adjuvant therapy
  • Hypofractionation
  • Local control
  • Boost