International Journal of Radiation Oncology * Biology * Physics
Volume 57, Issue 5 , Pages 1239-1246 , 1 December 2003

Patterns of breast recurrence in a pilot study of brachytherapy confined to the lumpectomy site for early breast cancer with six years' minimum follow-up

  • Francisco Perera, M.D., F.R.C.P.(C.)

      Affiliations

    • Department of Radiation Oncology, London Regional Cancer Centre, London, Ontario, Canada
    • Corresponding Author InformationReprint requests to: Dr. Francisco Perera, London Regional Cancer Centre, 790 Commissioners Road East, London, Ontario, Canada, N6A 4L6. Tel: (519) 685-8650; Fax: (519) 685-8627;
  • ,
  • Edward Yu, M.D., F.R.C.P.(C.)

      Affiliations

    • Department of Radiation Oncology, London Regional Cancer Centre, London, Ontario, Canada
  • ,
  • Jay Engel, M.B., F.R.C.S.(C.)

      Affiliations

    • Department of Surgical Oncology, London Health Sciences Centre, London, Ontario, Canada
  • ,
  • Ronald Holliday, M.D., F.R.C.S.(C.)

      Affiliations

    • Department of Surgical Oncology, London Health Sciences Centre, London, Ontario, Canada
  • ,
  • Leslie Scott, M.D., F.R.C.S.(C.)

      Affiliations

    • Department of Surgical Oncology, London Health Sciences Centre, London, Ontario, Canada
  • ,
  • Frank Chisela, Ph.D.

      Affiliations

    • Department of Radiation Oncology, Vassar Brothers Hospital, Poughkeepsie, New York, USA
  • ,
  • Varagur Venkatesan, M.D., F.R.C.P.(C.)

      Affiliations

    • Department of Radiation Oncology, London Regional Cancer Centre, London, Ontario, Canada
    • Department of Surgical Oncology, London Health Sciences Centre, London, Ontario, Canada
    • Department of Radiation Oncology, Vassar Brothers Hospital, Poughkeepsie, New York, USA

Received 12 August 2002 ,Revised 29 April 2003 ,Accepted 1 May 2003.

References 

  1. Fisher B, Redmond C, Poisson R, et al.  Eight-year results of a randomized clinical trial comparing total mastectomy and lumpectomy with or without irradiation in the treatment of breast cancer. N Engl J Med. 1991;320:822–828
  2. Fisher B, Anderson S, Redmond C, et al.  Re-analysis and results after 12 years of follow-up in a randomized clinical trial comparing total mastectomy with lumpectomy with or without irradiation in the treatment of breast cancer. N Engl J Med. 1995;333:1456–1461
  3. Veronesi U, Marubini E, Mariani L, et al.  Radiotherapy after breast-conserving surgery in small breast carcinoma (Long-term results of a randomized trial). Ann Oncol. 2001;12:997–1003
  4. Clark RM, Whelan T, Levine M, et al.  Randomized clinical trial of breast irradiation following lumpectomy and axillary dissection for node-negative breast cancer (An update. Ontario Clinical Oncology Group). J Natl Cancer Inst. 1996;88:1659–1664
  5. Liljegren GG, Holmberg L, Adami HO, et al. for the Uppsala-Orebro Breast Cancer Study Group. Sector resection with or without postoperative radiotherapy for stage I breast cancer: Five-year results of a randomized trial. J Natl Cancer Inst 1994;86:717–722
  6. Fisher B, Bryant J, Dignam JJ, et al.  Tamoxifen, radiation therapy, or both for prevention of ipsilateral breast tumour recurrence after lumpectomy in women with invasive breast cancers of one centimeter or less. J Clin Oncol. 2002;20(20):4141–4149
  7. Fyles A, Manchul L, McCready D, et al. Preliminary results of randomized study of tamoxifen alone or tamoxifen and breast radiation in women over 50 years of age with T1/2 N0 disease. ASTRO 2001 Nov 4–8 (abstract #190)
  8. Holli K, Saaristo R, Isola J, Joensuu H, Hakama M. Lumpectomy with or without postoperative radiotherapy for breast cancer with favourable prognostic features (Results of a randomized study). Br J Cancer. 2001;84:164–169
  9. Ribeiro G, Magee B, Swindell R, Harris M, Banerjee S. The Christie Hospital breast conservation trial (An update at eight years from inception). Clin Oncol (R Coll Radiol). 1993;5(5):278–283
  10. Fentiman IS, Poole C, Tong D, et al. Inadequacy of iridium implant as sole treatment for operable breast cancer. Eur J Cancer 1996;32A(4):608–611
  11. Boyages J, Recht A, Connolly JL, et al.  Early breast cancer (Predictors of breast recurrence for patients treated with conservative surgery and radiation therapy). Radiother Oncol. 1990;19(1):29–41
  12. Ellston CW, Ellis IO. Pathologic prognostic factors in breast cancer. I. The value of histologic grade in breast cancer (Experience from a large study with long-term follow-up). Histopathology. 1991;19:403–441
  13. Perera F, Chisela F, Engel J, Venkatesan V. Method of localization of the lumpectomy site for high dose rate brachytherapy after conservative breast surgery for T1 and T2 breast cancer. Int J Radiat Oncol Biol Phys. 1995;31(4):959–965
  14. Kaplan EL, Meier P. Nonparametric estimation from incomplete observations. J Am Stat Assoc. 1958;53:457–481
  15. Perera F, Engel J, Holliday R, et al.  Local resection and brachytherapy confined to the lumpectomy site for early breast cancer (A pilot study). J Surg Oncol. 1997;65:263–268
  16. Chauvet B, Reynaud-Bougnoux A, Calais G, et al.  Prognostic significance of breast relapse after conservative treatment in node-negative early breast cancer. Int J Radiat Oncol Biol Phys. 1990;19:1125–1130
  17. Fowble B, Solin LJ, Schulz DJ, et al.  Breast recurrence following conservative surgery and radiation (Patterns of failure, prognosis, and pathologic findings from mastectomy specimens with implications for treatment). Int J Radiat Oncol Biol Phys. 1990;19:833–842
  18. Kurtz JM, Amalric R, Brandone H, et al.  Local recurrence after breast-conserving surgery and radiotherapy (Frequency, time course and prognosis). Cancer. 1989;63:1912–1917
  19. Price P, Walsh G, McKinna AJ, et al.  Patterns of breast relapse after local excision plus or minus radiotherapy for early breast cancer. Radiother Oncol. 1988;13:53–60
  20. Recht A, Silen W, Schnitt SJ, et al.  Time-course of local recurrence following conservative surgery and radiotherapy for early stage breast cancer. Int J Radiat Oncol Biol Phys. 1988;15:255–261
  21. Smith TE, Daesung L, Turner B, Carter D, Haffty BG. True recurrence vs. new primary ipsilateral breast tumor relapse (An analysis of clinical and pathologic differences and their implications in natural history, prognoses, and therapeutic management). Int J Radiat Oncol Biol Phys. 2000;48(5):1281–1289
  22. Bartelink H, Horiot J, Poortmans P, et al.  Recurrence rates after treatment of breast cancer with standard radiotherapy with or without additional radiation. N Engl J Med. 2001;345(19):1378–1387
  23. King TA, Bolton JS, Kuske RR, Fuhrman GM, Scroggins TG, Jiang XZ. Long-term results of wide-field brachytherapy as the sole method of radiation therapy after segmental mastectomy for t(is,1,2) breast cancer. Am J Surg. 2000;180(4):299–304
  24. Vicini FA, Baglan KL, Kestin LL, et al.  Accelerated treatment of breast cancer. J Clin Oncol. 2001;19:1993–2001
  25. Baglan KL, Martinez AA, Frazier RC, et al.  The use of high-dose-rate brachytherapy alone after lumpectomy in patients with early-stage breast cancer treated with breast-conserving therapy. Int J Radiat Oncol Biol Phys. 2001;50:1003–1011
  26. Wazer DE, Berle L, Graham R, et al.  Preliminary results of a phase I/II study of HDR brachytherapy alone for T1/T2 breast cancer. Int J Radiat Oncol Biol Phys. 2002;53(4):889–897
  27. Polgar C, Sedyok Z, Fodor J, et al.  Sole brachytherapy of the tumor bed after conservative surgery for T1 breast cancer (Five-year results of a phase I-II study and initial findings of a randomized phase III trial). J Surg Oncol. 2002;80(3):121–128
  28. Gump FE, Shikora S, Habif DV, Kister S, Logerfo P, Estabrook A. The extent and distribution of cancer in breasts with palpable primary tumors. Ann Surg. 1986;204(4):384–390
  29. Holland R, Veling S, Mravunac M, Hendriks J. Histologic multifocality of Tis, T1–2 breast carcinomas. Cancer. 1985;56:979–990
  30. Schwartz GF, Patchesfsky AS, Feig SA, Shaber GS, Schwartz AB. Multicentricity of non-palpable breast cancer. Cancer. 1980;45(12):2913–2916
  31. Vaidya JS, Vyas JJ, Chinoy RF, Merchant N, Sharma OP, Mittra I. Multicentricity of breast cancer (Whole-organ analysis and clinical implications). Br J Cancer. 1996;74(5):820–824
  32. Anastassiades O, Iakovou E, Stavridou N, Gogas J, Karameris A. Multicentricity in breast cancer: A study of 366 cases. Am J Clin Pathol 1993;99(3):238–243
  33. Zhang ZD. Whole organ giant section histopathologic studies on breast cancer. I. Multicentric lesions. Chung Hua Chung Liu Tsa Chih. 1991;13(5):356–358
  34. Tinnemans JG, Wobbes T, van der sluis RF, Lubbers EJ, de Boer HH. Multicentricity in nonpalpable breast cancer and its implications for treatment. Am J Surg. 1986;151(3):334–338
  35. Sarnelli R, Squartini F. Multicentricity in breast cancer (A submacroscopic study). Pathol Annu. 1986;21:143–158
  36. Rosen PP, Frachia AA, Urban JA, et al.  “Residual” mammary carcinoma following simulated partial mastectomy. Cancer. 1975;35:739–747
  37. Holland R, Connolly JL, Gelman R, et al.  The presence of an extensive intraductal component following limited excision correlates with prominent residual disease in the remainder of the breast. J Clin Oncol. 1990;8:113–118
  38. Vicini FA, Eberlein TJ, Connolly JL, et al.  The optimal extent of resection for patients with stages I and II breast cancer treated with conservative surgery and radiotherapy. Ann Surg. 1991;214(3):200–204
  39. Schnitt SJ, Abner A, Gelman R, et al.  The relationship between microscopic margins of resection and the risk of local recurrence in patients with breast cancer treated with breast-conserving surgery and radiation therapy. Cancer. 1994;74:1746–1751
  40. Whelan T, Clark R, Roberts R, et al. Ipsilateral breast tumor recurrence post lumpectomy is predictive of subsequent mortality: Results from a randomized trial. Int J Radiat Oncol Biol Phys 1994;30:11–16
  41. Fisher B, Anderson S, Fisher ER, et al.  Significance of ipsilateral breast tumor recurrence after lumpectomy. Lancet. 1991;338(8763):327–331
  42. Fisher ER, Anderson S, Redmond C, Fisher B. Ipsilateral breast tumor recurrence and survival following lumpectomy and irradiation (Pathological findings from NSABP protocol B-06). Semin Surg Oncol. 1992;8:161–166
  43. Veronesi U, Marubini E, Del Vecchio M, et al.  Local recurrences and distant metastases after conservative breast cancer treatments. Partly independent events. J Natl Cancer Inst. 1995;87(1):19–27

PII: S0360-3016(03)00816-2

doi: 10.1016/S0360-3016(03)00816-2

International Journal of Radiation Oncology * Biology * Physics
Volume 57, Issue 5 , Pages 1239-1246 , 1 December 2003