TNBC: radiotherapy omission not safe after breast-conserving surgery in elders

  • Haque W & al.
  • Breast J
  • 4 Jul 2019

  • curated by Emily Willingham, PhD
  • Univadis Clinical Summaries
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Takeaway

  • Omission of adjuvant radiotherapy (ART) is tied to poorer survival after breast-conserving surgery (BCS) in elderly women with T1-2N0 triple-negative breast cancer (TNBC).

Why this matters

  • Randomized trial data suggested that ART could be omitted after BCS in women ≥70 years with T1-N0, estrogen receptor-positive breast cancer, but generalizability to TNBC was unclear.

Key results

  • Factors for ART omission included higher comorbidities, lower income, margin-positive resection, age ≥80 years, academic center treatment, and receipt of chemotherapy (all P<.05>
  • With a median follow-up of 38.0 (range, 25.6‐50.9) months, 5-year OS was higher with ART than without (77.2% vs 55.3%, P<.001>
    • Findings were supported in propensity-matched analysis (68.2% vs 56.6%; P<.001>
  • The survival gap persisted regardless of stratification by age, tumor stage, and chemotherapy administration.
  • In multivariate analysis, ART omission predicted a 2.19-fold increased mortality risk (P<.001>

Study design

  • Information from the National Cancer Database for 8631 women aged ≥70 years (6283 received ART; 2243 did not) with BCS-treated TNBC.
  • Funding: None disclosed.

Limitations

  • Retrospective analysis based on database information.

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