Breast-Conserving Treatment With or Without Radiotherapy in Ductal Carcinoma In Situ: 15-Year Recurrence Rates and Outcome After a Recurrence, From the EORTC 10853 Randomized Phase III Trial

Mila Donker; Saskia Litiere; Gustavo Werutsky; Jean-Pierre Julien; Ian Fentiman; Roberto Agresti; Philippe Rouanet; Christine Tunon de lara; Harry Bartelink; Nicole Duez; Emiel J. T. Rutgers; Nina Bijker

doi:10.1200/JCO.2013.49.5077

Breast-Conserving Treatment With or Without Radiotherapy in Ductal Carcinoma In Situ: 15-Year Recurrence Rates and Outcome After a Recurrence, From the EORTC 10853 Randomized Phase III Trial

Mila Donker, Saskia Litiere, Gustavo Werutsky, Jean-Pierre Julien, Ian Fentiman, Roberto Agresti, Philippe Rouanet, Christine Tunon de lara, Harry Bartelink, Nicole Duez, Emiel J. T. Rutgers, Nina Bijker^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

305 Citations (Scopus)

Abstract

Purpose

Adjuvant radiotherapy (RT) after a local excision (LE) for ductal carcinoma in situ (DCIS) aims at reduction of the incidence of a local recurrence (LR). We analyzed the long-term risk on developing LR and its impact on survival after local treatment for DCIS.

Patients and Methods

Between 1986 and 1996, 1,010 women with complete LE of DCIS less than 5 cm were randomly assigned to no further treatment (LE group, n = 503) or RT (LE+RT group, n = 507). The median follow-up time was 15.8 years.

Results

Radiotherapy reduced the risk of any LR by 48% (hazard ratio [HR], 0.52; 95% CI, 0.40 to 0.68; P <.001). The 15-year LR-free rate was 69% in the LE group, which was increased to 82% in the LE+RT group. The 15-year invasive LR-free rate was 84% in the LE group and 90% in the LE+RT group (HR, 0.61; 95% CI, 0.42 to 0.87). The differences in LR in both arms did not lead to differences in breast cancer-specific survival (BCSS; HR, 1.07; 95% CI, 0.60 to 1.91) or overall survival (OS; HR, 1.02; 95% CI, 0.71 to 1.44). Patients with invasive LR had a significantly worse BCSS (HR, 17.66; 95% CI, 8.86 to 35.18) and OS (HR, 5.17; 95% CI, 3.09 to 8.66) compared with those who did not experience recurrence. A lower overall salvage mastectomy rate after LR was observed in the LE+RT group than in the LE group (13% v 19%, respectively).

Conclusion

At 15 years, almost one in three nonirradiated women developed an LR after LE for DCIS. RT reduced this risk by a factor of 2. Although women who developed an invasive recurrence had worse survival, the long-term prognosis was good and independent of the given treatment.

Original language	English
Pages (from-to)	4054-4059
Number of pages	6
Journal	Journal of Clinical Oncology
Volume	31
Issue number	32
DOIs	https://doi.org/10.1200/JCO.2013.49.5077
Publication status	Published - 10 Nov 2013

Keywords

INVASIVE LOCAL RECURRENCE
CONSERVATION TREATMENT
EUROPEAN ORGANIZATION
SECTOR RESECTION
CANCER
RADIATION
THERAPY
TRIAL-10853
LUMPECTOMY
TAMOXIFEN

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1200/JCO.2013.49.5077

Cite this

Donker, M., Litiere, S., Werutsky, G., Julien, J.-P., Fentiman, I., Agresti, R., Rouanet, P., de lara, C. T., Bartelink, H., Duez, N., Rutgers, E. J. T., & Bijker, N. (2013). Breast-Conserving Treatment With or Without Radiotherapy in Ductal Carcinoma In Situ: 15-Year Recurrence Rates and Outcome After a Recurrence, From the EORTC 10853 Randomized Phase III Trial. Journal of Clinical Oncology, 31(32), 4054-4059. https://doi.org/10.1200/JCO.2013.49.5077

@article{a1595fb6c10e4067bb4d1bafd7161e6b,

title = "Breast-Conserving Treatment With or Without Radiotherapy in Ductal Carcinoma In Situ: 15-Year Recurrence Rates and Outcome After a Recurrence, From the EORTC 10853 Randomized Phase III Trial",

abstract = "Purpose Adjuvant radiotherapy (RT) after a local excision (LE) for ductal carcinoma in situ (DCIS) aims at reduction of the incidence of a local recurrence (LR). We analyzed the long-term risk on developing LR and its impact on survival after local treatment for DCIS. Patients and Methods Between 1986 and 1996, 1,010 women with complete LE of DCIS less than 5 cm were randomly assigned to no further treatment (LE group, n = 503) or RT (LE+RT group, n = 507). The median follow-up time was 15.8 years. Results Radiotherapy reduced the risk of any LR by 48% (hazard ratio [HR], 0.52; 95% CI, 0.40 to 0.68; P <.001). The 15-year LR-free rate was 69% in the LE group, which was increased to 82% in the LE+RT group. The 15-year invasive LR-free rate was 84% in the LE group and 90% in the LE+RT group (HR, 0.61; 95% CI, 0.42 to 0.87). The differences in LR in both arms did not lead to differences in breast cancer-specific survival (BCSS; HR, 1.07; 95% CI, 0.60 to 1.91) or overall survival (OS; HR, 1.02; 95% CI, 0.71 to 1.44). Patients with invasive LR had a significantly worse BCSS (HR, 17.66; 95% CI, 8.86 to 35.18) and OS (HR, 5.17; 95% CI, 3.09 to 8.66) compared with those who did not experience recurrence. A lower overall salvage mastectomy rate after LR was observed in the LE+RT group than in the LE group (13% v 19%, respectively). Conclusion At 15 years, almost one in three nonirradiated women developed an LR after LE for DCIS. RT reduced this risk by a factor of 2. Although women who developed an invasive recurrence had worse survival, the long-term prognosis was good and independent of the given treatment.",

keywords = "INVASIVE LOCAL RECURRENCE, CONSERVATION TREATMENT, EUROPEAN ORGANIZATION, SECTOR RESECTION, CANCER, RADIATION, THERAPY, TRIAL-10853, LUMPECTOMY, TAMOXIFEN",

author = "Mila Donker and Saskia Litiere and Gustavo Werutsky and Jean-Pierre Julien and Ian Fentiman and Roberto Agresti and Philippe Rouanet and {de lara}, {Christine Tunon} and Harry Bartelink and Nicole Duez and Rutgers, {Emiel J. T.} and Nina Bijker",

year = "2013",

month = nov,

day = "10",

doi = "10.1200/JCO.2013.49.5077",

language = "English",

volume = "31",

pages = "4054--4059",

journal = "Journal of Clinical Oncology",

issn = "0732-183X",

publisher = "American Society of Clinical Oncology",

number = "32",

}

Donker, M, Litiere, S, Werutsky, G, Julien, J-P, Fentiman, I, Agresti, R, Rouanet, P, de lara, CT, Bartelink, H, Duez, N, Rutgers, EJT & Bijker, N 2013, 'Breast-Conserving Treatment With or Without Radiotherapy in Ductal Carcinoma In Situ: 15-Year Recurrence Rates and Outcome After a Recurrence, From the EORTC 10853 Randomized Phase III Trial', Journal of Clinical Oncology, vol. 31, no. 32, pp. 4054-4059. https://doi.org/10.1200/JCO.2013.49.5077

Breast-Conserving Treatment With or Without Radiotherapy in Ductal Carcinoma In Situ: 15-Year Recurrence Rates and Outcome After a Recurrence, From the EORTC 10853 Randomized Phase III Trial. / Donker, Mila; Litiere, Saskia; Werutsky, Gustavo et al.
In: Journal of Clinical Oncology, Vol. 31, No. 32, 10.11.2013, p. 4054-4059.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Breast-Conserving Treatment With or Without Radiotherapy in Ductal Carcinoma In Situ

T2 - 15-Year Recurrence Rates and Outcome After a Recurrence, From the EORTC 10853 Randomized Phase III Trial

AU - Donker, Mila

AU - Litiere, Saskia

AU - Werutsky, Gustavo

AU - Julien, Jean-Pierre

AU - Fentiman, Ian

AU - Agresti, Roberto

AU - Rouanet, Philippe

AU - de lara, Christine Tunon

AU - Bartelink, Harry

AU - Duez, Nicole

AU - Rutgers, Emiel J. T.

AU - Bijker, Nina

PY - 2013/11/10

Y1 - 2013/11/10

N2 - Purpose Adjuvant radiotherapy (RT) after a local excision (LE) for ductal carcinoma in situ (DCIS) aims at reduction of the incidence of a local recurrence (LR). We analyzed the long-term risk on developing LR and its impact on survival after local treatment for DCIS. Patients and Methods Between 1986 and 1996, 1,010 women with complete LE of DCIS less than 5 cm were randomly assigned to no further treatment (LE group, n = 503) or RT (LE+RT group, n = 507). The median follow-up time was 15.8 years. Results Radiotherapy reduced the risk of any LR by 48% (hazard ratio [HR], 0.52; 95% CI, 0.40 to 0.68; P <.001). The 15-year LR-free rate was 69% in the LE group, which was increased to 82% in the LE+RT group. The 15-year invasive LR-free rate was 84% in the LE group and 90% in the LE+RT group (HR, 0.61; 95% CI, 0.42 to 0.87). The differences in LR in both arms did not lead to differences in breast cancer-specific survival (BCSS; HR, 1.07; 95% CI, 0.60 to 1.91) or overall survival (OS; HR, 1.02; 95% CI, 0.71 to 1.44). Patients with invasive LR had a significantly worse BCSS (HR, 17.66; 95% CI, 8.86 to 35.18) and OS (HR, 5.17; 95% CI, 3.09 to 8.66) compared with those who did not experience recurrence. A lower overall salvage mastectomy rate after LR was observed in the LE+RT group than in the LE group (13% v 19%, respectively). Conclusion At 15 years, almost one in three nonirradiated women developed an LR after LE for DCIS. RT reduced this risk by a factor of 2. Although women who developed an invasive recurrence had worse survival, the long-term prognosis was good and independent of the given treatment.

AB - Purpose Adjuvant radiotherapy (RT) after a local excision (LE) for ductal carcinoma in situ (DCIS) aims at reduction of the incidence of a local recurrence (LR). We analyzed the long-term risk on developing LR and its impact on survival after local treatment for DCIS. Patients and Methods Between 1986 and 1996, 1,010 women with complete LE of DCIS less than 5 cm were randomly assigned to no further treatment (LE group, n = 503) or RT (LE+RT group, n = 507). The median follow-up time was 15.8 years. Results Radiotherapy reduced the risk of any LR by 48% (hazard ratio [HR], 0.52; 95% CI, 0.40 to 0.68; P <.001). The 15-year LR-free rate was 69% in the LE group, which was increased to 82% in the LE+RT group. The 15-year invasive LR-free rate was 84% in the LE group and 90% in the LE+RT group (HR, 0.61; 95% CI, 0.42 to 0.87). The differences in LR in both arms did not lead to differences in breast cancer-specific survival (BCSS; HR, 1.07; 95% CI, 0.60 to 1.91) or overall survival (OS; HR, 1.02; 95% CI, 0.71 to 1.44). Patients with invasive LR had a significantly worse BCSS (HR, 17.66; 95% CI, 8.86 to 35.18) and OS (HR, 5.17; 95% CI, 3.09 to 8.66) compared with those who did not experience recurrence. A lower overall salvage mastectomy rate after LR was observed in the LE+RT group than in the LE group (13% v 19%, respectively). Conclusion At 15 years, almost one in three nonirradiated women developed an LR after LE for DCIS. RT reduced this risk by a factor of 2. Although women who developed an invasive recurrence had worse survival, the long-term prognosis was good and independent of the given treatment.

KW - INVASIVE LOCAL RECURRENCE

KW - CONSERVATION TREATMENT

KW - EUROPEAN ORGANIZATION

KW - SECTOR RESECTION

KW - CANCER

KW - RADIATION

KW - THERAPY

KW - TRIAL-10853

KW - LUMPECTOMY

KW - TAMOXIFEN

U2 - 10.1200/JCO.2013.49.5077

DO - 10.1200/JCO.2013.49.5077

M3 - Article

SN - 0732-183X

VL - 31

SP - 4054

EP - 4059

JO - Journal of Clinical Oncology

JF - Journal of Clinical Oncology

IS - 32

ER -