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. 2019 Nov 4;14(1):190.
doi: 10.1186/s13014-019-1394-x.

Omission of adjuvant radiotherapy following breast-conserving surgery for elderly women with early-stage pure mucinous breast carcinoma

San-Gang Wu  1 , Feng-Yan Li  2 , Jun Wang  1 , Chen-Lu Lian  1 , Juan Zhou  3 , Zhen-Yu He  4
Affiliations

Omission of adjuvant radiotherapy following breast-conserving surgery for elderly women with early-stage pure mucinous breast carcinoma

San-Gang Wu et al. Radiat Oncol. .

Abstract

Background: We aimed to ascertain population-based practice patterns and survival outcomes of postoperative radiotherapy following breast conserving-surgery (BCS) in elderly women (aged ≥65 years) with early-stage pure mucinous breast carcinoma (PMBC).

Methods: Patients aged ≥65 years diagnosed with T1-2N0 and hormone receptor-positive PMBC between 1990 and 2010 were identified from the Surveillance, Epidemiology, and End Results database. Binomial logistic regression, Kaplan-Meier method, Multivariate Cox proportional hazards models, and propensity score matching (PSM) were used for statistical analysis.

Results: We enrolled 3416 patients, including 1225 (35.9%) and 2191 (64.1%) in the no-radiotherapy and radiotherapy cohorts, respectively. The percentage of patients receiving postoperative radiotherapy following BCS was significantly lower after 2004 (59.5% between 2004 and 2010), relative to that before 2004 (71.1% between 1990 and 2003; P < 0.001). Before PSM, the 10-year breast cancer-specific survival (BCSS) rates were 98.1 and 93.2% for patients with and without postoperative radiotherapy (log-rank test, P < 0.001), respectively. In the PSM cohort, receiving postoperative radiotherapy was associated with better BCSS rates, with 10-year BCSS rates of 97.6 and 94.5% in patients with and without postoperative radiotherapy, respectively (log-rank test, P = 0.001). Multivariate Cox proportional analysis indicated that receiving postoperative radiotherapy was an independent factor associated with better BCSS before (P < 0.001) and after PSM (P = 0.001), relative to those not receiving postoperative radiotherapy.

Conclusions: This study shows a decreasing utilization of postoperative radiotherapy following BCS of elderly PMBC patients over time. However, postoperative radiotherapy following BCS should be administered for elderly women with PMBC owing to independent association with better survival.

Keywords: Elderly; Prognosis; Propensity score matching; Pure mucinous breast cancer; Radiotherapy.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Patient selection flowchart of the study
Fig. 2
Fig. 2
Change in the use of postoperative radiotherapy following breast-conserving surgery in patients with pure mucinous breast carcinoma, according to the period of diagnosis
Fig. 3
Fig. 3
Comparison of breast cancer-specific survival between the non-radiotherapy and adjuvant radiotherapy cohorts before (a) and after (b) propensity score matching
See this image and copyright information in PMC

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