Adjuvant Radiotherapy in Older Women with Early Breast Cancer: Benefits Questioned

Adding irradiation to tamoxifen after lumpectomy was associated with modestly lower risk for local-regional recurrence but no survival advantage.

Although radiotherapy (RT) after lumpectomy lowers risk for ipsilateral recurrence, not all women may experience substantial benefits from RT. CALGB 9343, a randomized trial conducted from 1994 to 1999, was designed to evaluate lumpectomy plus tamoxifen with or without breast irradiation in women aged ≥70 with stage I, estrogen receptor–positive breast cancer. This report documents long-term follow-up in 636 participants.

At median follow-up of 12.6 years, the benefit of whole-breast RT was statistically significant (hazard ratio, 0.18; P<0.001), yet modest with respect to local-regional recurrence: At 10 years, 98% of patients who received tamoxifen plus RT were free from local-regional recurrences, compared with 90% of those who received o…

Reviewing Author

Henry Mark Kuerer, MD, PhD, FACS

Disclosures

Speaker's BureauPhysicians’ Education Resource, LLC

RoyaltiesMcGraw-Hill Professional; UpToDate, Inc.

Editorial BoardsAnnals of Surgical Oncology

Leadership Positions in Professional SocietiesAmerican Society of Breast Surgeons (Chair, Publications Committee)