Omitting Adjuvant Radiotherapy for Hormone Receptor‒Positive Early-Stage Breast Cancer in Old Age: A Propensity Score Matched SEER Analysis.
- Author:
Yi Jun KIM
1
;
Kyung Hwan SHIN
;
Kyubo KIM
Author Information
- Publication Type:Original Article
- Keywords: Adjuvant radiotherapy; Aged; Breast neoplasms; SEER database; Estrogen receptors; Progesterone receptors; Tumor grade; Tumor size
- MeSH: Aged; Breast Neoplasms*; Breast*; Epidemiology; Female; Humans; Mastectomy, Segmental; Multivariate Analysis; Propensity Score*; Radiotherapy; Radiotherapy, Adjuvant*; Receptors, Estrogen; Receptors, Progesterone
- From:Cancer Research and Treatment 2019;51(1):326-336
- CountryRepublic of Korea
- Language:English
- Abstract: PURPOSE: The purpose of this study was to investigate the non-inferiority of omitting radiotherapy (RT) after breast-conserving surgery (BCS) for hormone receptor (HR)‒positive T1N0 breast cancer in elderly women. MATERIALS AND METHODS: From 2004 to 2014, HR-positive T1N0 breast cancer patients aged 50 years or older and receiving BCS were retrieved from the Surveillance, Epidemiology, and End RESULTS: 18 database. After propensity score matching between the no-RT and RT groups, univariate and multivariate analyses were performed. Identified prognostic factors were used to stratify the risk groups. In each risk group, 10-year cancer-specific survival (CSS) rates were compared between the no-RT and RT groups. RESULTS: After propensity score matching, the numbers of patients in the no-RT and RT groups were both 18,586. For patients who satisfied both a tumor size of 1-10 mm and a tumor grade of 1-2, omitting RT did not decrease the CSS rate at any age group, ranging from ≥ 50 to ≥ 85 years; for patients aged ≥ 50 years, the 10-year CSS rates in the no-RT and RT groups were 97.2% and 96.8%, respectively (adjusted hazard ratio, 0.862; p=0.312). However, for patients with a tumor size of 11-20 mm or tumor grade of 3-4, RT significantly increased the CSS rate irrespective of age. CONCLUSION: RT after BCS for HR-positive T1N0 breast cancer in elderly women might be omitted without causing a decrease in the CSS rate, but only in patients who satisfy both a small tumor size (≤ 10 mm) and low tumor grade (1-2).
