This Article Full Text Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Save to my personal folders Download to citation manager Rights & Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Buchholz, T. A. Articles by Hunt, K. K. Search for Related Content PubMed PubMed Citation Articles by Buchholz, T. A. Articles by Hunt, K. K. Social Bookmarking                            What's this?

Impact of Systemic Treatment on Local Control for Patients With Lymph Node–Negative Breast Cancer Treated With Breast-Conservation Therapy

From the Departments of Radiation Oncology, Biomathematics, Breast Medical Oncology, and Surgical Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, TX.

Address reprint requests to Thomas A. Buchholz, MD, Department of Radiation Oncology, The University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Blvd, Box 97, Houston, TX 77030; email: tbuchhol{at}mdanderson.org

PURPOSE: To determine the impact of tamoxifen and chemotherapy on local control for breast cancer patients treated with breast-conservation therapy.

PATIENTS AND METHODS: The data from 484 breast cancer patients who were treated with breast-conserving surgery and radiation were analyzed. Only patients with lymph node–negative disease were studied to provide comparative groups with a similar stage of disease and a similar competing risk for distant metastases. Actuarial local control rates of the 277 patients treated with systemic therapy (128, chemotherapy with or without tamoxifen; 149, tamoxifen alone) were compared with the rates for the 207 patients who received no systemic treatment. Only 10% of the patients had positive (2%), close (3%), or unknown margin status (5%).

RESULTS: Patients treated with systemic therapy had improved 5-year (97.5% v 89.8%) and 8-year (95.6% v 85.2%) local control rates compared with those that did not receive systemic treatment (P = .004, log-rank test). There was no statistical difference in local control between patients treated with chemotherapy and patients treated with tamoxifen alone (P = .219). Systemic treatment, margin status, young patient age, estrogen and progesterone receptor status, and primary tumor size were analyzed in a Cox regression analysis. The use of systemic treatment was the most powerful predictor of local control: patients who did not receive systemic treatment had a relative risk of local recurrence of 3.3 (95% confidence interval, 1.5 to 7.5; P = .004).

CONCLUSION: In this retrospective analysis, systemic therapy appears to contribute to long-term local control in patients with lymph node–negative breast cancer treated with breast-conservation therapy.

Presented at the Eighty-Second Annual Meeting of the American Radium Society, London, England, April 1-5, 2000.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Facebook    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				T. A. Buchholz Radiation Therapy for Early-Stage Breast Cancer after Breast-Conserving Surgery N. Engl. J. Med., January 1, 2009; 360(1): 63 - 70. [Full Text] [PDF]

				B. D. Smith, C. P. Gross, G. L. Smith, D. H. Galusha, J. E. Bekelman, and B. G. Haffty Effectiveness of radiation therapy for older women with early breast cancer. J Natl Cancer Inst, May 17, 2006; 98(10): 681 - 690. [Abstract] [Full Text] [PDF]

				J. R. Bellon, S. E. Come, R. S. Gelman, I. C. Henderson, L. N. Shulman, B. J. Silver, J. R. Harris, and A. Recht Sequencing of Chemotherapy and Radiation Therapy in Early-Stage Breast Cancer: Updated Results of a Prospective Randomized Trial J. Clin. Oncol., March 20, 2005; 23(9): 1934 - 1940. [Abstract] [Full Text] [PDF]

				J. R. Bellon and J. R. Harris Chemotherapy and Radiation Therapy for Breast Cancer: What Is the Optimal Sequence? J. Clin. Oncol., January 1, 2005; 23(1): 5 - 7. [Full Text] [PDF]

				C. I. Sartor, B. L. Peterson, S. Woolf, T. J. FitzGerald, F. Laurie, A. J. Turrisi, J. Bogart, I. C. Henderson, and L. Norton Effect of Addition of Adjuvant Paclitaxel on Radiotherapy Delivery and Locoregional Control of Node-Positive Breast Cancer: Cancer and Leukemia Group B 9344 J. Clin. Oncol., January 1, 2005; 23(1): 30 - 40. [Abstract] [Full Text] [PDF]

				I. E. Smith and G. M. Ross Breast Radiotherapy after Lumpectomy -- No Longer Always Necessary N. Engl. J. Med., September 2, 2004; 351(10): 1021 - 1023. [Full Text] [PDF]

				G. M. Freedman, A. L. Hanlon, B. L. Fowble, P. R. Anderson, and N. Nicoloau Recursive Partitioning Identifies Patients at High and Low Risk for Ipsilateral Tumor Recurrence After Breast-Conserving Surgery and Radiation J. Clin. Oncol., October 1, 2002; 20(19): 4015 - 4021. [Abstract] [Full Text] [PDF]