Journal of Clinical Oncology, 2005 ASCO Annual Meeting Proceedings.
Vol 23, No 16S (June 1 Supplement), 2005: 517
© 2005 American Society of Clinical Oncology

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Abstract

Survival after IBTR in NSABP Node Negative Protocols B-13, B-14, B-19, B-20 and B-23

Stanford Univ Sch of Medcn, Stanford, CA; Univ of Pittsburgh GSPH and NSABP Biostatist, Pittsburgh, PA; Aultman Health Fdn and NSABP Operations Ctr, Canton, OH; NSABP Operations Ctr, Pittsburgh, PA; Allegheny General Hospital, Pittsburgh, PA

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Breast irradiation and adjuvant therapies decrease ipsilateral breast tumor recurrences (IBTR) after breast conserving surgery. We have previously reported poor outcomes in women experiencing IBTR in NSABP node positive protocols. The overall survival in the first five years following IBTR is approximately 60%. We postulated that the risk of mortality after IBTR in node negative breast cancers would be similar. Methods: IBTR events were calculated in patients randomized on recent NSABP node negative prospective randomized trials. Women with estrogen-receptor negative tumors were entered into B-13, B-19, B-23 while those with estrogen-receptor positive tumors into B-14 and B-20. Only randomized eligible patients with follow-up were considered. Breast conserving surgery was performed in 3799 of these women, constituting our population at risk. Results: As of December 31, 2003, the median time on study for this cohort was 166.2 months (Table 1). Ten-year cumulative incidence of IBTR across all protocols was 6.0%. Rates were highest in the placebo arms of protocols B-13 and B-14. The overall survival in the first five years after IBTR was 75.7%. Five year survival after IBTR in ER- protocols was 68.6% versus 80.0% in ER+ trials. Conclusion: The cumulative risk of death after IBTR in patients with node-negative breast cancer is considerable but somewhat lower than that in patients with positive nodes. These results lend further support to the concept that IBTR is a powerful predictive marker of risk for metastatic disease and death.

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Abstract presentation from the 2005 ASCO Annual Meeting