Local-regional control in breast cancer patients with a possible genetic predisposition

Laura Freedman, Thomas A. Buchholz, Howard D. Thames, Eric A. Strom, Marsha D. McNeese, Gabriel N. Hortobagyi, S. Eva Singletary, Keith M. Heaton, Kelly K. Hunt

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Purpose: Local control rates for breast cancer in genetically predisposed women are poorly defined. Because such a small percentage of breast cancer patients have proven germline mutations, surrogates, such as a family history for breast cancer, have been used to examine this issue. The purpose of this study was to evaluate local-regional control following breast conservation therapy (BCT) in patients with bilateral breast cancer and a breast cancer family history. Methods and Materials: We retrospectively reviewed records of all 58 patients with bilateral breast cancer and a breast cancer family history treated in our institution between 1959 and 1998. The primary surgical treatment was a breast-conserving procedure in 55 of the 116 breast cancer cases and a mastectomy in 61. The median follow-up was 68 months for the BCT patients and 57 months for the mastectomy-treated patients. Results: Eight local-regional recurrences occurred in the 55 cases treated with BCT, resulting in 5- and 10-year actuarial local-regional control rates of 86% and 76%, respectively. In the nine cases that did not receive radiation as a component of their BCT, four developed local-regional recurrences (5- and 10-year local-regional control rates of BCT without radiation: 49% and 49%). The 5- and 10-year actuarial local-regional control rates for the 46 cases treated with BCT and radiation were 94% and 83%, respectively. In these cases, there were two late local recurrences, developing at 8 years and 9 years, respectively. A log rank comparison of radiation versus no radiation actuarial data was significant at p = 0.009. In the cases treated with BCT, a multivariate analysis of radiation use, patient age, degree of family history, margin status, and stage revealed that only the use of radiation was associated with improved local control (Cox regression analysis p = 0.021). The 10-year actuarial rates of local-regional control following mastectomy with and without radiation were 91% and 89%, respectively. Conclusions: Patients with a possible genetic predisposition to breast cancer had low 5-year rates of local recurrence when treated with breast conserving surgery and radiation, but the local failure rate exceeded 50% when radiation was omitted. Our data are consistent with the hypothesis that patients with an underlying genetic predisposition develop cancers with radiosensitive phenotypes. Copyright (C) 2000 Elsevier Science Inc.

Original languageEnglish
Pages (from-to)951-957
Number of pages7
JournalInternational Journal of Radiation Oncology Biology Physics
Volume48
Issue number4
DOIs
StatePublished - Nov 1 2000
Externally publishedYes

Fingerprint

Genetic Predisposition to Disease
breast
Segmental Mastectomy
cancer
Breast Neoplasms
Radiation
conservation
Mastectomy
therapy
radiation
Recurrence
histories
Germ-Line Mutation
Breast
Multivariate Analysis
phenotype
Regression Analysis
Phenotype
mutations
surgery

Keywords

  • Breast cancer
  • Breast conservation therapy
  • Genetic predisposition
  • Radiation

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Radiation

Cite this

Local-regional control in breast cancer patients with a possible genetic predisposition. / Freedman, Laura; Buchholz, Thomas A.; Thames, Howard D.; Strom, Eric A.; McNeese, Marsha D.; Hortobagyi, Gabriel N.; Singletary, S. Eva; Heaton, Keith M.; Hunt, Kelly K.

In: International Journal of Radiation Oncology Biology Physics, Vol. 48, No. 4, 01.11.2000, p. 951-957.

Research output: Contribution to journalArticle

Freedman, L, Buchholz, TA, Thames, HD, Strom, EA, McNeese, MD, Hortobagyi, GN, Singletary, SE, Heaton, KM & Hunt, KK 2000, 'Local-regional control in breast cancer patients with a possible genetic predisposition', International Journal of Radiation Oncology Biology Physics, vol. 48, no. 4, pp. 951-957. https://doi.org/10.1016/S0360-3016(00)00761-6
Freedman, Laura ; Buchholz, Thomas A. ; Thames, Howard D. ; Strom, Eric A. ; McNeese, Marsha D. ; Hortobagyi, Gabriel N. ; Singletary, S. Eva ; Heaton, Keith M. ; Hunt, Kelly K. / Local-regional control in breast cancer patients with a possible genetic predisposition. In: International Journal of Radiation Oncology Biology Physics. 2000 ; Vol. 48, No. 4. pp. 951-957.
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AU - Freedman, Laura

AU - Buchholz, Thomas A.

AU - Thames, Howard D.

AU - Strom, Eric A.

AU - McNeese, Marsha D.

AU - Hortobagyi, Gabriel N.

AU - Singletary, S. Eva

AU - Heaton, Keith M.

AU - Hunt, Kelly K.

PY - 2000/11/1

Y1 - 2000/11/1

N2 - Purpose: Local control rates for breast cancer in genetically predisposed women are poorly defined. Because such a small percentage of breast cancer patients have proven germline mutations, surrogates, such as a family history for breast cancer, have been used to examine this issue. The purpose of this study was to evaluate local-regional control following breast conservation therapy (BCT) in patients with bilateral breast cancer and a breast cancer family history. Methods and Materials: We retrospectively reviewed records of all 58 patients with bilateral breast cancer and a breast cancer family history treated in our institution between 1959 and 1998. The primary surgical treatment was a breast-conserving procedure in 55 of the 116 breast cancer cases and a mastectomy in 61. The median follow-up was 68 months for the BCT patients and 57 months for the mastectomy-treated patients. Results: Eight local-regional recurrences occurred in the 55 cases treated with BCT, resulting in 5- and 10-year actuarial local-regional control rates of 86% and 76%, respectively. In the nine cases that did not receive radiation as a component of their BCT, four developed local-regional recurrences (5- and 10-year local-regional control rates of BCT without radiation: 49% and 49%). The 5- and 10-year actuarial local-regional control rates for the 46 cases treated with BCT and radiation were 94% and 83%, respectively. In these cases, there were two late local recurrences, developing at 8 years and 9 years, respectively. A log rank comparison of radiation versus no radiation actuarial data was significant at p = 0.009. In the cases treated with BCT, a multivariate analysis of radiation use, patient age, degree of family history, margin status, and stage revealed that only the use of radiation was associated with improved local control (Cox regression analysis p = 0.021). The 10-year actuarial rates of local-regional control following mastectomy with and without radiation were 91% and 89%, respectively. Conclusions: Patients with a possible genetic predisposition to breast cancer had low 5-year rates of local recurrence when treated with breast conserving surgery and radiation, but the local failure rate exceeded 50% when radiation was omitted. Our data are consistent with the hypothesis that patients with an underlying genetic predisposition develop cancers with radiosensitive phenotypes. Copyright (C) 2000 Elsevier Science Inc.

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KW - Breast cancer

KW - Breast conservation therapy

KW - Genetic predisposition

KW - Radiation

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