Impact of the mode of detection on outcome in breast cancer patients treated with breast-conserving therapy

被引:6
作者
Kini, VR
Vicini, FA
Victor, SJ
Dmuchowski, CF
Rebner, M
Martinez, AA
机构
[1] William Beaumont Hosp, Dept Radiat Oncol, Royal Oak, MI 48073 USA
[2] William Beaumont Hosp, Dept Biostat, Royal Oak, MI 48073 USA
[3] William Beaumont Hosp, Dept Radiol, Royal Oak, MI 48073 USA
来源
AMERICAN JOURNAL OF CLINICAL ONCOLOGY-CANCER CLINICAL TRIALS | 1999年 / 22卷 / 05期
关键词
breast neoplasms; mode of detection; radiotherapy; breast-conserving therapy; local recurrence and survival;
D O I
10.1097/00000421-199910000-00001
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
The impact of the mode of detection on outcome in patients with early stage breast cancer treated with breast-conserving therapy (BCT) was reviewed. Between January 1980 and December 1987, 400 cases of stage I and LI breast cancer were created with BCT. All patients underwent an excisional biopsy, external beam irradiation (RT) to the whole breast (45-50 Gy), and a boost to 60 Gy to the tumor bed. One hundred twenty-four cases (31%) were mammographically detected, whereas 276 (69%) were clinically detected. Median follow-up was 9.2 years. Patients whose cancers were detected by mammography more frequently had smaller tumors (90% T1 vs. 62%, p < 0.0001), lower overall disease stage (78% stage I vs. 47%, p < 0.0001), were older at diagnosis (78% >50 years vs. 54%,p < 0.001), less frequently received chemotherapy (8% vs. 21%, p = 0.001), and had an improved disease-free survival (DFS) (80% vs. 70%, p = 0.014), overall survival (OS) (82% vs. 70%, p = 0.005), and cause-specific survival (CSS) (88% vs. 77%, p = 0.003) at 10 years. However, controlling for tumor size, nodal status, and age, no statistically significant differences in the 5- and 10-year actuarial rates of local recurrence (LR), DFS, CSS, or OS were seen based on the mode of detection. Initial mode of detection was the strongest predictor of outcome after a LR. The 3-year DFS rate after LR was significantly better in initially mammographically detected versus clinically detected cases (100% vs. 61%, p = 0.011). Patients with mammographically detected breast cancer generally have smaller tumors and lower overall disease stage at presentation. However, the mode of detection;does not independently appear to affect the success of BCT in these patients.
引用
收藏
页码:429 / 435
页数:7
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