Published in:
01-06-2009 | Breast Oncology
Local Control, Toxicity, and Cosmesis in Women Younger Than 50 Enrolled Onto the American Society of Breast Surgeons MammoSite Radiation Therapy System Registry Trial
Authors:
A. J. Khan, MD, F. Vicini, MD, P. Beitsch, MD, B. Haffty, MD, C. Quiet, MD, A. Keleher, MD, D. Garcia, MD, H. Snider, MD, M. Gittleman, MD, V. Zannis, MD, H. Kuerer, MD, PhD, E. Whitacre, MD, P. Whitworth Jr, MD, R. Fine, MD
Published in:
Annals of Surgical Oncology
|
Issue 6/2009
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Background
The American Society of Breast Surgeons enrolled women onto a registry trial to prospectively study patients treated with the MammoSite Radiation Therapy System (RTS) breast brachytherapy device. This report examines local recurrence (LR), toxicity, and cosmesis as a function of age in women enrolled onto the trial.
Methods
A total of 1449 primary early-stage breast cancers were treated in 1440 women. Of these, 130 occurred in women younger than 50 years of age. Fisher’s exact test was performed to correlate age (<50 vs. ≥ 50 years) with toxicity and with cosmesis. The association of age with LR failure times was investigated by fitting a parametric model.
Results
Women younger than 50 were more likely to develop fat necrosis: 4.6% (6 of 130) vs. 1.8% (24 of 1319) (P = .0456). Other toxicities were comparable. At 2 years, cosmesis was excellent or good in 87% of assessable women aged <50 years (n = 74) and in 94% of assessable older women (n = 751) (P = .0197). At 3 years, this difference disappeared: excellent or good in 90% (56 of 62) of younger women vs. 93% (573 of 614) of older women (P = .2902). The crude LR rate for the group was 1.7% (25 of 1449). There was no statistically significant difference in LR as a function of age. In women <50, 3.1% (4 of 130) developed a LR; in the older patients, 1.6% (21 of 1319) developed LR (3-year actuarial LR rates, 2.9% vs. 1.7%, respectively; P = .2284).
Conclusions
Accelerated partial breast irradiation with the MammoSite RTS results in low toxicity and produces similar cosmesis and local control at 3 years in women younger than 50 when compared with older women.