Longest follow-up of early Blair patients

Barcelona, ​​Spain: Chemotherapy to treat early-stage breast cancer or radiotherapy after breast-conserving surgery combined with tamoxifen reduces the risk of recurrence in the same breast over the next 10 years, with little difference thereafter. It also does not improve overall survival after 30 years.

Ian Kankler, emeritus professor of clinical oncology at the University of Edinburgh, UK, said Tuesday.^th Today (Friday) at the European Breast Cancer Congress, one of the longest and most recent follow-ups to a randomized controlled clinical trial of breast-conserving therapy is perhaps unique, providing important information to long-term breast cancer survivors and their physicians. clarified.

“Long-term follow-up is essential in breast cancer trials to understand the full picture,” he said. “These data challenge the idea that radiation therapy improves long-term survival by preventing cancer recurrence in the same breast.”

The Scottish Breast Conservation Trial followed 585 patients aged 70 years or younger for 30 years. After being diagnosed with early-stage breast cancer, I underwent breast-conserving surgery after chemotherapy and systemic therapy such as tamoxifen, depending on whether the cancer was caused by the hormone estrogen. Patients were also randomly assigned to receive or not receive radiotherapy after surgery.

Ten years after radiotherapy, 60% of women randomized to receive radiotherapy had recurrence of disease in the same breast (known as “locoregional recurrence” or “ipsilateral breast tumor recurrence”). has decreased significantly. I didn’t. However, after her first decade, the annual risk of recurrence was similar in both groups, as was overall survival. Thirty years after her treatment, 24% of the women who received radiation therapy were alive, compared with 27.5% of the women who did not receive radiation therapy. .

Professor Kunkler said: This suggests that while radiation therapy may help prevent some deaths from breast cancer, there are still some deaths from other causes, such as heart and blood vessel disease, especially long hours after radiation therapy. This is because it can cause

“The benefit of radiotherapy in terms of fewer local recurrences is only available in the first decade after radiotherapy. Thereafter, local recurrence rates are similar whether patients receive radiotherapy or not.

“Patients with breast cancer can live for decades after treatment. These findings warrant comparison with other studies of similar design through long-term, careful follow-up.” Follow-up of randomized breast cancer clinical trials is often constrained by a lack of resources, and funders need to support the collection of long-term outcome data.The results I am presenting today are: “Such data show that conventional notions about the long-term anticancer effects of radiotherapy can be challenged.”

“It is important to note that every woman with breast cancer is different and will develop many forms of breast cancer. It should be done after careful discussion between the patient and physician, considering the risk of recurrence over time and of treatment-related toxicity.”

Dr. Tanja Spanic is co-chair of the European Breast Cancer Conference, patient advocate and Europa Donna – European Breast Cancer CoalitionShe was not involved in the research; she said: To help me live healthier and longer? As this very long-term follow-up of breast cancer patients shows, these are complex questions that patients and their physicians need to consider when choosing the best treatment. More studies following these patients for decades are needed to get the full picture. ”

(end)

Abstract number: 2, “Randomized Controlled Trials of Breast Conservation Therapy: A 30-Year Analysis of Scottish Breast Conservation Trials,” Friday 18 November, “Questions for Innovation in Radiotherapy” Clinical Symposium, 10.30-12.00 hrs CET, Room 111.