Salvage treatment conferred favorable outcomes in early-stage breast cancer

Issue: September 25, 2014

SAN FRANCISCO — Women with early-stage breast cancer who experienced local recurrence after breast-conserving surgery achieved favorable outcomes with salvage therapy, according to study results presented at the Breast Cancer Symposium.

Survival outcomes among patients who developed local recurrence were comparable regardless of initial treatment with whole-breast or accelerated partial-breast irradiation, results showed.

Maha Saada Jawad, MD, of the department of radiation oncology at Oakland University William Beaumont School of Medicine in Royal Oak, Mich., evaluated data from 1,654 women who underwent breast-conserving surgery for early-stage breast cancer between 1980 and 2013. All women also underwent whole-breast or accelerated partial-breast irradiation.

Local recurrence occurred as a first event in 112 patients (7%). Median time to local recurrence was 6.6 years (range, 0.1-28). Eighty-seven of these women underwent whole-breast irradiation and 25 underwent accelerated partial-breast irradiation.

Median follow-up among patients who experienced local recurrence was 14 years (range, 0.7-31). Follow-up was significantly shorter for patients who underwent accelerated partial-breast vs. whole-breast irradiation (10 years vs. 16 years; P=.01).

Most patients who experienced local recurrence underwent mastectomy with or without chemotherapy (75%). Nineteen percent of patients underwent wide local excision with or without radiation therapy, 2% of patients received chemotherapy and 4% received another therapy.

Survival outcomes were similar among patients who experienced local recurrence who underwent whole-breast or accelerated partial-breast irradiation following contralateral breast failure (P=.83), regional recurrence (P=.93) and distant metastases (P=.26).

Ninety-two percent of all patients who experienced local recurrence achieved 5-year cause-specific survival, and 82% achieved 10-year cause-specific survival. OS rates were 91% at 5 years and 81% at 10 years.

Type of irradiation was not associated with statistically significant differences in cause-specific survival (P=.82) or OS (P=.77).

“Patients who developed local recurrence following breast-conserving therapy for early-stage breast cancer had excellent clinical outcomes at 5 and 10 years, demonstrating effective salvage treatment in this cohort of patients,” Jawad and colleagues wrote. “No differences were noted between patients undergoing accelerated partial-breast irradiation vs. whole-breast irradiation. Further identification of histopathologic patterns between first cancer and local recurrence is currently underway.”

For more information:

Jawad MS. Abstract #66. Presented at: Breast Cancer Symposium; Sept. 4-6, 2014; San Francisco.

Disclosures: The researchers report no relevant financial disclosures.