Biomedical Papers, 2014 (vol. 158), issue 3

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2014, 158(3):461-464 | 10.5507/bp.2013.032

Omission of adjuvant radiation therapy in elderly patients with low risk breast cancer undergoing breast-conserving surgery - two center experience

David Vranaa,c,d, Jiri Gatekb, Lucie Lukesovaa, Tomas Vazane, Bohuslav Melichara, Marketa Pospiskovaf, Ivan Svachg
a Department of Oncology, Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic
b Department of Surgery, Atlas Hospital, Tomas Bata University in Zlin, Zlin
c Institute of Molecular and Translational Medicine, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc
d Toxicogenomics Unit, National Institute of Public Health, Prague
e Cytologic and Histopathologic Laboratory, Zlin
f Oncology center, Krajska nemocnice T.Bati a.s., Zlin
g Department of Surgery I, University Hospital Olomouc

Introduction: Breast cancer is, now often diagnosed in patients older than 70 years due to longer life expectancy. The usual treatment is mastectomy to obviate radiotherapy or breast-conserving surgery followed by radiotherapy. The aim of this study was to investigate the need for adjuvant radiotherapy in older patients and the consequences of omitting radiotherapy following conservative surgery.

Methods: An extensive database search was made of patients who had been treated for breast cancer at the Department of Oncology, University Hospital Olomouc and the Atlas Hospital in Zlin (2004-2008). We identified 738 patients of whom 190 patients (25.7%) were older than 70 years of age. These were followed up for progression-free and overall survival. The cause of death was checked for breast cancer relapse.

Results: In total only 9 patients undergoing breast saving surgery were ultimately identified. No patient had confirmed local recurrence during the follow up period: Two patients have died due to distant metastasis without local relapse and one patient has died for reasons other than breast cancer.

Conclusion: Omitting radiotherapy after breast saving surgery provides an opportunity for women to undergo breast saving surgery and avoid 7 weeks of radiotherapy. This could significantly improve patient quality of life. In our of many years experience and from published randomized data, this procedure is safe for a select group of patients 70 years of age and older.

Keywords: breast cancer, radiation-therapy, elderly patients

Received: November 21, 2012; Accepted: April 18, 2013; Published: May 3, 2013


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