The University of Southampton
University of Southampton Institutional Repository

Ipsilateral breast tumour relapse: local recurrence versus new primary and the effect of whole breast radiotherapy on the rate of new primaries

Ipsilateral breast tumour relapse: local recurrence versus new primary and the effect of whole breast radiotherapy on the rate of new primaries
Ipsilateral breast tumour relapse: local recurrence versus new primary and the effect of whole breast radiotherapy on the rate of new primaries
Purpose

The justification for partial breast radiotherapy after breast conservation surgery assumes that ipsilateral breast tumor relapses (IBTR) outside the index quadrant are mostly new primary (NP) tumors that develop despite radiotherapy. We tested the hypothesis that whole-breast radiotherapy (WBRT) is ineffective in preventing NP by comparing development rates in irradiated and contralateral breasts after tumor excision and WBRT.

Methods and Materials

We retrospectively reviewed 1,410 women with breast cancer who were entered into a prospective randomized trial of radiotherapy fractionation and monitored annually for ipsilateral breast tumor relapses (IBTR) and contralateral breast cancer (CLBC). Cases of IBTR were classified into local recurrence (LR) or NP tumors based on location and histology and were subdivided as definite or likely depending on clinical data. Rates of ipsilateral NP and CLBC were compared over a 15-year period of follow-up.

Results

At a median follow-up of 10.1 years, there were 150 documented cases of IBTR: 118 (79%) cases were definite or likely LR; 27 (18%) cases were definite or likely NP; and 5 (3%) cases could not be classified. There were 71 cases of CLBC. The crude proportion of definite-plus-likely NP was 1.9% (27/1,410) patients compared with 5% (71/1,410) CLBC patients. Cumulative incidence rates at 5, 10, and 15 years were 0.8%, 2.0%, and 3.5%, respectively, for definite-plus-likely NP and 2.4%, 5.8%, and 7.9%, respectively for CLBC, suggesting a difference in the rates of NP and CLBC.

Conclusions

This analysis suggests that WBRT reduces the rate of ipsilateral NP tumors. The late presentation of NP has implications for the reporting of trials that are testing partial breast radiotherapy.
breast cancer, ipsilateral, contralateral, relapse, radiotherapy
0360-3016
19-25
Gujral, D.M.
82f35824-7d29-4dbf-bf52-6d4f397b0679
Sumo, G.
d759b8d3-8128-4716-b34a-04a27c67d9b5
Owen, J.R.
6ccc7eea-56fc-4aea-b207-d29a2e4b879d
Ashton, A.
8202ef6c-495f-4592-8748-271c74134945
Bliss, J.M.
84e229a6-c019-47ef-92bb-0875b13f5c18
Haviland, J.S.
569aa43b-15bd-4e9d-b4a5-e68a84334cfe
Yarnold, J.R.
0e51cc2f-3eb1-464f-bf61-d2ac2e86e958
Gujral, D.M.
82f35824-7d29-4dbf-bf52-6d4f397b0679
Sumo, G.
d759b8d3-8128-4716-b34a-04a27c67d9b5
Owen, J.R.
6ccc7eea-56fc-4aea-b207-d29a2e4b879d
Ashton, A.
8202ef6c-495f-4592-8748-271c74134945
Bliss, J.M.
84e229a6-c019-47ef-92bb-0875b13f5c18
Haviland, J.S.
569aa43b-15bd-4e9d-b4a5-e68a84334cfe
Yarnold, J.R.
0e51cc2f-3eb1-464f-bf61-d2ac2e86e958

Gujral, D.M., Sumo, G., Owen, J.R., Ashton, A., Bliss, J.M., Haviland, J.S. and Yarnold, J.R. (2011) Ipsilateral breast tumour relapse: local recurrence versus new primary and the effect of whole breast radiotherapy on the rate of new primaries. International Journal of Radiation Oncology*Biology*Physics, 79 (1), 19-25. (doi:10.1016/j.ijrobp.2009.10.074). (PMID:20471183)

Record type: Article

Abstract

Purpose

The justification for partial breast radiotherapy after breast conservation surgery assumes that ipsilateral breast tumor relapses (IBTR) outside the index quadrant are mostly new primary (NP) tumors that develop despite radiotherapy. We tested the hypothesis that whole-breast radiotherapy (WBRT) is ineffective in preventing NP by comparing development rates in irradiated and contralateral breasts after tumor excision and WBRT.

Methods and Materials

We retrospectively reviewed 1,410 women with breast cancer who were entered into a prospective randomized trial of radiotherapy fractionation and monitored annually for ipsilateral breast tumor relapses (IBTR) and contralateral breast cancer (CLBC). Cases of IBTR were classified into local recurrence (LR) or NP tumors based on location and histology and were subdivided as definite or likely depending on clinical data. Rates of ipsilateral NP and CLBC were compared over a 15-year period of follow-up.

Results

At a median follow-up of 10.1 years, there were 150 documented cases of IBTR: 118 (79%) cases were definite or likely LR; 27 (18%) cases were definite or likely NP; and 5 (3%) cases could not be classified. There were 71 cases of CLBC. The crude proportion of definite-plus-likely NP was 1.9% (27/1,410) patients compared with 5% (71/1,410) CLBC patients. Cumulative incidence rates at 5, 10, and 15 years were 0.8%, 2.0%, and 3.5%, respectively, for definite-plus-likely NP and 2.4%, 5.8%, and 7.9%, respectively for CLBC, suggesting a difference in the rates of NP and CLBC.

Conclusions

This analysis suggests that WBRT reduces the rate of ipsilateral NP tumors. The late presentation of NP has implications for the reporting of trials that are testing partial breast radiotherapy.

Text
Gujral et al published 2011.pdf - Other
Download (252kB)

More information

Published date: 1 January 2011
Keywords: breast cancer, ipsilateral, contralateral, relapse, radiotherapy
Organisations: Faculty of Health Sciences

Identifiers

Local EPrints ID: 365597
URI: http://eprints.soton.ac.uk/id/eprint/365597
ISSN: 0360-3016
PURE UUID: 595e6c8b-e9d1-427a-8b7e-2f70b4d52397

Catalogue record

Date deposited: 10 Jun 2014 13:36
Last modified: 14 Mar 2024 16:58

Export record

Altmetrics

Contributors

Author: D.M. Gujral
Author: G. Sumo
Author: J.R. Owen
Author: A. Ashton
Author: J.M. Bliss
Author: J.S. Haviland
Author: J.R. Yarnold

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of http://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×