International Journal of Radiation Oncology * Biology * Physics
Volume 73, Issue 4 , Pages 1055-1060, 15 March 2009

Outcomes After Breast Conservation Treatment With Radiation in Women With Prior Nonbreast Malignancy and Subsequent Invasive Breast Carcinoma

  • Deepika Nemani, B.S.

      Affiliations

    • Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA
  • ,
  • Neha Vapiwala, M.D.

      Affiliations

    • Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA
    • Corresponding Author InformationReprint requests to: Neha Vapiwala, M.D., Department of Radiation Oncology, 2 Donner Building, 3400 Spruce Street, Hospital of University of Pennsylvania, Philadelphia, PA 19104. Tel: (215) 662-2337; Fax: (215) 349-5445
  • ,
  • Wei-Ting Hwang, Ph.D.

      Affiliations

    • Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, PA
  • ,
  • Lawrence J. Solin, M.D.

      Affiliations

    • Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA

Received 30 March 2008; received in revised form 20 May 2008; accepted 28 May 2008. published online 17 October 2008.

Purpose

Little information has been reported regarding outcomes after treatment for patients with early-stage invasive breast cancer and a prior nonbreast malignancy. This report analyzes the outcomes in patients with Stage I and II breast cancer after breast conservation treatment (BCT) with a prior nonbreast malignancy.

Methods and Materials

The study cohort comprised 66 women with invasive breast cancer and a prior nonbreast malignancy. All patients were treated with breast conservation surgery followed by definitive breast irradiation between 1978 and 2003. Median ages at diagnosis of invasive breast cancer and prior malignancy were 57 and 50 years, respectively. The median interval between the prior malignancy and breast cancer was 7.0 years. Median and mean follow-up times after BCT were 5.3 and 7.0 years.

Results

The 5-year and 10-year overall survival rates were 94% (95% confidence interval [CI], 82–98%) and 78% (95% CI, 59–89%), respectively. There were 4 patients (6%) with local failure and 10 patients (15%) with distant metastases. The 10-year rate of local failure rate was 5% (95% CI, 2–16%) and freedom from distant metastases was 78% (95% CI, 61–88%). No obvious differences in survival or local control were noted compared with the reported results in the literature for patients with invasive breast cancer alone.

Conclusions

Both overall survival and local control at 5 and 10 years were comparable to rates observed in early-stage breast cancer patients without a prior malignancy. Prior nonbreast malignancy is not a contraindication to BCT, if the primary cancer is effectively controlled.

Breast carcinoma, Breast conservation treatment, Prior malignancy, Radiation treatment

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 Presented in part at the First Annual Breast Cancer Symposium of the American Society of Clinical Oncology (ASCO), September 8, 2007, San Francisco, CA.

 Supported in part by a grant from The Breast Cancer Research Foundation.

 Conflict of interest: none.

PII: S0360-3016(08)00964-4

doi:10.1016/j.ijrobp.2008.05.049

International Journal of Radiation Oncology * Biology * Physics
Volume 73, Issue 4 , Pages 1055-1060, 15 March 2009