Selective radiation therapy for ductal carcinoma in situ following breast-conserving surgery according to age and margin width

Korean radiation oncology group 11-04 and 16-02 studies

Kyubo Kim, Jin Hee Kim, Yongbae Kim, Chang-Ok Suh, Kyung Hwan Shin, Jin Ho Kim, Tae Hyun Kim, So Youn Jung, Doo Ho Choi, Won Park, Seung Do Ahn, Su Ssan Kim, Ji Woon Yea, Min Kyu Kang, Dong Won Kim, Yi Jun Kim

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Purpose: The optimal indications for omitting adjuvant radiation therapy (RT) after breast-conserving surgery are still controversial in ductal carcinoma in situ (DCIS) of the breast. The purpose of this study was to validate the role of postoperative RT in DCIS patients aged ≤ 50 years and with tumor margin widths of < 1 cm, both of which have been proven to be high-risk features for recurrence in cohorts not receiving RT. Methods: Using two multicenter retrospective studies on DCIS, a pooled analysis was performed among patients aged ≤ 50 years and with margin widths < 1 cm. All patients underwent breast-conserving surgery. Two hundred thirty-two patients received postoperative RT, while 54 did not. The median follow-up period was 77 months (range, 2–190 months) and 70 months (range, 5–166 months) in the patients who received RT and those who did not, respectively. Results: The patients who received RT had larger tumors (p< 0.001), higher nuclear grade (p< 0.001), closer margin width (p< 0.001), and negative estrogen receptor expression (p= 0.010) compared with those who did not receive RT. During the follow-up period, there were 17 ipsilateral breast tumor recurrences (IBTRs) as follows: invasive carcinoma in 10 patients and DCIS in seven. In the univariate analysis, the treatment with RT and human epidermal growth factor receptor 2 (HER2) status were significant risk factors for IBTR. The 7-year IBTR rates with and without postoperative RT were 3.6% and 13.1%, respectively (p= 0.008). HER2-positive tumors had a higher IBTR rate than the HER2-negative tumors (7-year rate, 13.6% vs. 3.9%; p=0.003). Conclusion: Postoperative RT following breast-conserving surgery significantly reduced the 7-year IBTR rate in the DCIS patients aged ≤ 50 years and with margin widths < 1 cm. HER2 positivity was associated with increased IBTR in these patients.

Original languageEnglish
Pages (from-to)327-332
Number of pages6
JournalJournal of Breast Cancer
Volume20
Issue number4
DOIs
Publication statusPublished - 2017 Dec 1

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Radiation Oncology
Carcinoma, Intraductal, Noninfiltrating
Segmental Mastectomy
Radiotherapy
Recurrence
Breast Neoplasms
Neoplasms
Estrogen Receptors
Multicenter Studies
Breast
Retrospective Studies
Carcinoma

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

Cite this

Kim, Kyubo ; Kim, Jin Hee ; Kim, Yongbae ; Suh, Chang-Ok ; Shin, Kyung Hwan ; Kim, Jin Ho ; Kim, Tae Hyun ; Jung, So Youn ; Choi, Doo Ho ; Park, Won ; Ahn, Seung Do ; Kim, Su Ssan ; Yea, Ji Woon ; Kang, Min Kyu ; Kim, Dong Won ; Kim, Yi Jun. / Selective radiation therapy for ductal carcinoma in situ following breast-conserving surgery according to age and margin width : Korean radiation oncology group 11-04 and 16-02 studies. In: Journal of Breast Cancer. 2017 ; Vol. 20, No. 4. pp. 327-332.
@article{3f7c30eb087a468486335f4d7a4c979a,
title = "Selective radiation therapy for ductal carcinoma in situ following breast-conserving surgery according to age and margin width: Korean radiation oncology group 11-04 and 16-02 studies",
abstract = "Purpose: The optimal indications for omitting adjuvant radiation therapy (RT) after breast-conserving surgery are still controversial in ductal carcinoma in situ (DCIS) of the breast. The purpose of this study was to validate the role of postoperative RT in DCIS patients aged ≤ 50 years and with tumor margin widths of < 1 cm, both of which have been proven to be high-risk features for recurrence in cohorts not receiving RT. Methods: Using two multicenter retrospective studies on DCIS, a pooled analysis was performed among patients aged ≤ 50 years and with margin widths < 1 cm. All patients underwent breast-conserving surgery. Two hundred thirty-two patients received postoperative RT, while 54 did not. The median follow-up period was 77 months (range, 2–190 months) and 70 months (range, 5–166 months) in the patients who received RT and those who did not, respectively. Results: The patients who received RT had larger tumors (p< 0.001), higher nuclear grade (p< 0.001), closer margin width (p< 0.001), and negative estrogen receptor expression (p= 0.010) compared with those who did not receive RT. During the follow-up period, there were 17 ipsilateral breast tumor recurrences (IBTRs) as follows: invasive carcinoma in 10 patients and DCIS in seven. In the univariate analysis, the treatment with RT and human epidermal growth factor receptor 2 (HER2) status were significant risk factors for IBTR. The 7-year IBTR rates with and without postoperative RT were 3.6{\%} and 13.1{\%}, respectively (p= 0.008). HER2-positive tumors had a higher IBTR rate than the HER2-negative tumors (7-year rate, 13.6{\%} vs. 3.9{\%}; p=0.003). Conclusion: Postoperative RT following breast-conserving surgery significantly reduced the 7-year IBTR rate in the DCIS patients aged ≤ 50 years and with margin widths < 1 cm. HER2 positivity was associated with increased IBTR in these patients.",
author = "Kyubo Kim and Kim, {Jin Hee} and Yongbae Kim and Chang-Ok Suh and Shin, {Kyung Hwan} and Kim, {Jin Ho} and Kim, {Tae Hyun} and Jung, {So Youn} and Choi, {Doo Ho} and Won Park and Ahn, {Seung Do} and Kim, {Su Ssan} and Yea, {Ji Woon} and Kang, {Min Kyu} and Kim, {Dong Won} and Kim, {Yi Jun}",
year = "2017",
month = "12",
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doi = "10.4048/jbc.2017.20.4.327",
language = "English",
volume = "20",
pages = "327--332",
journal = "Journal of Breast Cancer",
issn = "1738-6756",
publisher = "Korean Breast Cancer Society",
number = "4",

}

Selective radiation therapy for ductal carcinoma in situ following breast-conserving surgery according to age and margin width : Korean radiation oncology group 11-04 and 16-02 studies. / Kim, Kyubo; Kim, Jin Hee; Kim, Yongbae; Suh, Chang-Ok; Shin, Kyung Hwan; Kim, Jin Ho; Kim, Tae Hyun; Jung, So Youn; Choi, Doo Ho; Park, Won; Ahn, Seung Do; Kim, Su Ssan; Yea, Ji Woon; Kang, Min Kyu; Kim, Dong Won; Kim, Yi Jun.

In: Journal of Breast Cancer, Vol. 20, No. 4, 01.12.2017, p. 327-332.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Selective radiation therapy for ductal carcinoma in situ following breast-conserving surgery according to age and margin width

T2 - Korean radiation oncology group 11-04 and 16-02 studies

AU - Kim, Kyubo

AU - Kim, Jin Hee

AU - Kim, Yongbae

AU - Suh, Chang-Ok

AU - Shin, Kyung Hwan

AU - Kim, Jin Ho

AU - Kim, Tae Hyun

AU - Jung, So Youn

AU - Choi, Doo Ho

AU - Park, Won

AU - Ahn, Seung Do

AU - Kim, Su Ssan

AU - Yea, Ji Woon

AU - Kang, Min Kyu

AU - Kim, Dong Won

AU - Kim, Yi Jun

PY - 2017/12/1

Y1 - 2017/12/1

N2 - Purpose: The optimal indications for omitting adjuvant radiation therapy (RT) after breast-conserving surgery are still controversial in ductal carcinoma in situ (DCIS) of the breast. The purpose of this study was to validate the role of postoperative RT in DCIS patients aged ≤ 50 years and with tumor margin widths of < 1 cm, both of which have been proven to be high-risk features for recurrence in cohorts not receiving RT. Methods: Using two multicenter retrospective studies on DCIS, a pooled analysis was performed among patients aged ≤ 50 years and with margin widths < 1 cm. All patients underwent breast-conserving surgery. Two hundred thirty-two patients received postoperative RT, while 54 did not. The median follow-up period was 77 months (range, 2–190 months) and 70 months (range, 5–166 months) in the patients who received RT and those who did not, respectively. Results: The patients who received RT had larger tumors (p< 0.001), higher nuclear grade (p< 0.001), closer margin width (p< 0.001), and negative estrogen receptor expression (p= 0.010) compared with those who did not receive RT. During the follow-up period, there were 17 ipsilateral breast tumor recurrences (IBTRs) as follows: invasive carcinoma in 10 patients and DCIS in seven. In the univariate analysis, the treatment with RT and human epidermal growth factor receptor 2 (HER2) status were significant risk factors for IBTR. The 7-year IBTR rates with and without postoperative RT were 3.6% and 13.1%, respectively (p= 0.008). HER2-positive tumors had a higher IBTR rate than the HER2-negative tumors (7-year rate, 13.6% vs. 3.9%; p=0.003). Conclusion: Postoperative RT following breast-conserving surgery significantly reduced the 7-year IBTR rate in the DCIS patients aged ≤ 50 years and with margin widths < 1 cm. HER2 positivity was associated with increased IBTR in these patients.

AB - Purpose: The optimal indications for omitting adjuvant radiation therapy (RT) after breast-conserving surgery are still controversial in ductal carcinoma in situ (DCIS) of the breast. The purpose of this study was to validate the role of postoperative RT in DCIS patients aged ≤ 50 years and with tumor margin widths of < 1 cm, both of which have been proven to be high-risk features for recurrence in cohorts not receiving RT. Methods: Using two multicenter retrospective studies on DCIS, a pooled analysis was performed among patients aged ≤ 50 years and with margin widths < 1 cm. All patients underwent breast-conserving surgery. Two hundred thirty-two patients received postoperative RT, while 54 did not. The median follow-up period was 77 months (range, 2–190 months) and 70 months (range, 5–166 months) in the patients who received RT and those who did not, respectively. Results: The patients who received RT had larger tumors (p< 0.001), higher nuclear grade (p< 0.001), closer margin width (p< 0.001), and negative estrogen receptor expression (p= 0.010) compared with those who did not receive RT. During the follow-up period, there were 17 ipsilateral breast tumor recurrences (IBTRs) as follows: invasive carcinoma in 10 patients and DCIS in seven. In the univariate analysis, the treatment with RT and human epidermal growth factor receptor 2 (HER2) status were significant risk factors for IBTR. The 7-year IBTR rates with and without postoperative RT were 3.6% and 13.1%, respectively (p= 0.008). HER2-positive tumors had a higher IBTR rate than the HER2-negative tumors (7-year rate, 13.6% vs. 3.9%; p=0.003). Conclusion: Postoperative RT following breast-conserving surgery significantly reduced the 7-year IBTR rate in the DCIS patients aged ≤ 50 years and with margin widths < 1 cm. HER2 positivity was associated with increased IBTR in these patients.

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U2 - 10.4048/jbc.2017.20.4.327

DO - 10.4048/jbc.2017.20.4.327

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JO - Journal of Breast Cancer

JF - Journal of Breast Cancer

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