Breast cancer recurrence: second breast conserving surgery plus RT shows promise

  • JAMA Oncol

  • curated by Miriam Davis, PhD
  • Univadis Clinical Summaries
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Takeaway

  • A phase 2 trial finds that patients with recurrence of breast cancer can be effectively and safely treated with a second breast-conserving surgery (BCS)+3-dimensional conformal partial breast reirradiation.  
  • Only 5.2% had 5-year ipsilateral recurrence.

Why this matters

  • Findings suggest that the procedure (second BCS+radiotherapy [RT]) is an effective alternative to mastectomy.

Study design

  • The NRG Oncology/RTOG 1014 phase 2 trial (n=58) was a single-group, prospective clinical trial of second BCS+3-dimensional, conformal, external beam partial breast reirradiation in patients who experienced a recurrence of a breast tumor that was
  • Funding: NIH.

Key results

  • Median follow-up was 5.5 years.
  • Only 5.2% (95% CI, 1.4%-13.2%) of patients had a 5-year in-breast recurrence.
  • The 5-year cumulative incidence of mastectomy was 10% (95% CI, 4%-20%).
  • The 5-year distant metastasis-free survival was 94.8% (95% CI, 84.8%-98.3%).
  • The 5-year OS was 94.8% (95% CI, 84.8%-98.3%).
  • 7% had grade 3 and 0 had ≥grade 4 late adverse events.

Limitations

  • Single-group trial.
  • Small sample size.