Post-surgery radiation in early breast cancer: survival analysis of registry data
(2002) Radiotherapy & Oncology — Vol. 64, n° 3, p. 281-290 (2002)
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- Background and purpose: Overviews of randomized trials have shown a small survival advantage with post-surgery radiation in early breast cancer. The present study attempts to extend this observation through a systematic analysis of population data. Materials and methods: This retrospective cohort study used the Surveillance, Epidemiology, and End Results (SEER) data on 83,776 women with breast cancer diagnosed between 1988 and 1997, stage T1-T2, node negative or node positive. The analysis was performed using the proportional hazard models. Results: Radiation was associated with a reduced mortality after breast-conserving surgery in node negative patients (hazard ratio 0.757; 95% confidence interval 0.709-0.809; using total mastectomy without radiation as reference) and in node positive patients (hazard ratio 0.777; 0.717-0.842), and after total mastectomy in node positive patients (hazard ratio 0.885; 0.815-0.961). Radiation was associated with an increased hazard ratio of 1.271 (1.080-1.496) after total mastectomy in node negative patients. Without radiation, breast-conserving surgery in node negative patients was associated with an increased hazard ratio (1.167; 1.036-1.314); a similar increase was not observed in node positive patients (hazard ratio 1.011; 0.884-1.155). In all cases, the best survival rates were found with combined breast-con serving surgery and radiation. Conclusion: The available data indicate that post-surgery radiation provides a survival advantage irrespective of the type of surgery in node positive patients. Likewise, survival advantage was observed with post-surgery radiation and breast-conserving procedure in node negative patients. (C) 2002 Elsevier Science Ireland Ltd. All rights reserved.
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Vinh-Hung, V., Burzykowski, T., Van de Steene, J., Storme, G., & Soete, G. (2002). Post-surgery radiation in early breast cancer: survival analysis of registry data. Radiotherapy & Oncology, 64(3), 281-290. https://doi.org/10.1016/S0167-8140(02)00105-6 (Original work published 2002)