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34 records – page 1 of 4.

Absolute risk reductions for local recurrence after postoperative radiotherapy after sector resection for ductal carcinoma in situ of the breast.

https://arctichealth.org/en/permalink/ahliterature87239
Source
J Clin Oncol. 2008 Mar 10;26(8):1247-52
Publication Type
Article
Date
Mar-10-2008
Author
Holmberg Lars
Garmo Hans
Granstrand Bengt
Ringberg Anita
Arnesson Lars-Gunnar
Sandelin Kerstin
Karlsson Per
Anderson Harald
Emdin Stefan
Author Affiliation
Division of Cancer Studies, Thomas Guy House, 3rd Floor, King's College London, Guy's Campus, London SE1 9RT, United Kingdom. lars.holmberg@kcl.ac.uk
Source
J Clin Oncol. 2008 Mar 10;26(8):1247-52
Date
Mar-10-2008
Language
English
Publication Type
Article
Keywords
Aged
Breast Neoplasms - radiotherapy - surgery
Carcinoma, Ductal, Breast - radiotherapy - surgery
Carcinoma, Intraductal, Noninfiltrating - radiotherapy - surgery
Female
Humans
Middle Aged
Neoplasm Recurrence, Local - etiology - prevention & control
Postoperative Period
Risk Reduction Behavior
Survival Rate
Sweden
Treatment Outcome
Abstract
PURPOSE: Evaluate the effects of radiotherapy after sector resection for ductal carcinoma in situ of the breast (DCIS) in patient groups as defined by age, size of the lesion, focality, completeness of excision and mode of detection. PATIENTS AND METHODS: A total of 1,067 women in Sweden were randomly assigned to either postoperative radiotherapy (RT) or control from 1987 to 1999, and 1,046 were followed for a mean of 8 years. The main outcome was new ipsilateral breast cancer events and distant metastasis-free survival analyzed according to intention to treat. RESULTS: There were 64 ipsilateral events in the RT arm and 141 in the control group corresponding to a risk reduction of 16.0 percentage points at 10 years (95% CI, 10.3% to 21.6%) and a relative risk of 0.40 (95% CI, 0.30 to 0.54). There was no statistically significant difference in distant metastasis-free survival. There was an effect modification by age, yielding a low effect of RT in women younger than 50, but substantial protection in women older than 60 years. The age effect was not confounded by focality, lesion size, completeness of excision, or detection mode. There was no group as defined by our stratification variables that had a low risk without radiotherapy. CONCLUSION: Our results indicate that younger women have a low protective effect of conventional RT after sector resection. Older women benefit substantially. We caution that the age effect was seen in a subgroup analysis. Further search with conventional clinical variables for a low risk group that does not need RT does not seem fruitful.
PubMed ID
18250350 View in PubMed
Less detail

Accrual rate-limiting factors in a Swedish randomised ductal carcinoma in situ (DCIS) trial - a demographic study.

https://arctichealth.org/en/permalink/ahliterature20554
Source
Eur J Cancer. 2000 Mar;36(4):483-8
Publication Type
Article
Date
Mar-2000
Author
A. Ringberg
T. Möller
Author Affiliation
Department of Plastic and Reconstructive Surgery, Malmö University Hospital, SE-205 02, Malmö, Sweden. anita.ringberg@plastsurg.mas.lu.se
Source
Eur J Cancer. 2000 Mar;36(4):483-8
Date
Mar-2000
Language
English
Publication Type
Article
Keywords
Breast Neoplasms - radiotherapy - surgery - therapy
Carcinoma in Situ - radiotherapy - surgery - therapy
Carcinoma, Ductal, Breast - radiotherapy - surgery - therapy
Female
Humans
Patient Selection
Radiotherapy, Adjuvant
Randomized Controlled Trials - methods
Research Support, Non-U.S. Gov't
Retrospective Studies
Abstract
In the last two decades the introduction of mammographic screening in the Western world has increased the number of diagnosed ductal carcinomas in situ (DCIS) considerably. In situ carcinoma of the breast is considered a heterogeneous disease, the natural history of which is not well known. Thus, appropriate treatment needs to be established. For this reason, a randomised trial studying the effect of breast conserving operation with or without postoperative radiotherapy was instituted in Southern Sweden in 1987. The aim of the present study was to assess patient accrual, identify limiting factors, and evaluate possible ways to influence these factors in order to increase patient accrual. Between 1987 and 1992, 331 patients had been registered with DCIS in the Regional Tumour Registry, 96 of which had been randomised. All 331 were subjected to chart review studying clinical data, mammography reports, cytology and pathology reports to identify inclusion and exclusion criteria according to the design of the trial. It was found that 5% (18/331) had an incorrect diagnosis of DCIS. According to the trial protocol 52% were not eligible (162/313). Fifty-eight per cent (n=88) of the 151 eligible patients had been correctly randomised. The most common reason for exclusion was lesion size. In 21% (66/313) the lesion was 'too large'. Several other limiting factors were identified such as in cytological and pathological definitions and reports, lack of information/awareness in certain physicians, patient reluctance to participate, which in turn may be influenced by the previous factor. With increased information to participating hospitals and considering the above given facts it should be possible to increase accrual from the 28% noted in the present consecutive demographic study to at least one-third of the diagnosed cases of DCIS.
PubMed ID
10717524 View in PubMed
Less detail

Adjuvant radiotherapy for early breast cancer: patterns of practice in Ontario.

https://arctichealth.org/en/permalink/ahliterature219973
Source
CMAJ. 1993 Nov 1;149(9):1273-7
Publication Type
Article
Date
Nov-1-1993
Author
T. Whelan
D. Marcellus
R. Clark
M. Levine
Author Affiliation
Ontario Cancer Foundation (Hamilton Regional Cancer Centre, Hamilton, Ont.
Source
CMAJ. 1993 Nov 1;149(9):1273-7
Date
Nov-1-1993
Language
English
Publication Type
Article
Keywords
Breast Neoplasms - radiotherapy - surgery
Combined Modality Therapy
Female
Humans
Mastectomy, Segmental
Ontario
Physician's Practice Patterns
Radiation Dosage
Retrospective Studies
Abstract
To determine the number of different radiation schedules used in Ontario to treat women with node-negative breast cancer after lumpectomy and axillary dissection.
Retrospective survey.
Princess Margaret Hospital, Toronto, and regional centres of the Ontario Cancer Treatment and Research Foundation (in Hamilton, London, Ottawa, Windsor and Thunder Bay).
A total of 551 of 1624 consecutive patients with node-negative breast cancer having undergone lumpectomy and axillary dissection who were eligible but did not participate in the Ontario Clinical Oncology Group randomized clinical trial and who received adjuvant breast irradiation between April 1984 and February 1989.
Schedules of radiotherapy received.
Forty-eight different radiotherapy schedules were identified. Total doses ranged from 4000 to 6600 cGy and the number of fractions from 15 to 30. Several different schedules were preferred: 322 patients (58.5%) received 4000 cGy in 15 or 16 fractions to the whole breast over 3 weeks plus a local boost of 1250 cGy to the primary site in 5 fractions over 1 week; 66 patients (12.0%) received 4000 cGy in 15 or 16 fractions over 3 weeks to the whole breast plus a local boost of 1000 cGy to the primary site in 4 or 5 fractions over 1 week; and 63 patients (11.5%) received 5000 cGy in 25 fractions to the whole breast in 5 weeks, without a boost.
The practice of adjuvant radiotherapy for early breast cancer in Ontario varies. The optimal radiation regimen for patients after lumpectomy should be determined through randomized clinical trials.
Notes
Cites: J Natl Cancer Inst. 1992 May 6;84(9):683-91314910
Cites: N Engl J Med. 1981 Jul 2;305(1):6-117015141
Cites: Int J Radiat Oncol Biol Phys. 1982 Jun;8(6):967-797107438
Cites: Cancer. 1984 Mar 1;53(5):1209-136362840
Cites: N Engl J Med. 1985 Mar 14;312(11):665-733883167
Cites: Acta Oncol. 1988;27(2):131-463390344
Cites: Radiother Oncol. 1991 Nov;22(3):159-601771255
Cites: Br J Radiol. 1989 Aug;62(740):679-942670032
Cites: Bull Cancer. 1990;77(8):793-72207368
Cites: Clin Oncol (R Coll Radiol). 1989 Sep;1(1):39-462486473
Cites: Clin Oncol (R Coll Radiol). 1990 Jan;2(1):27-342261385
Cites: Clin Oncol (R Coll Radiol). 1991 Sep;3(5):257-611931770
Cites: N Engl J Med. 1989 Mar 30;320(13):822-82927449
PubMed ID
8221482 View in PubMed
Less detail

[Benefits of intensive preoperative irradiation in combined therapy of breast cancer].

https://arctichealth.org/en/permalink/ahliterature240802
Source
Med Radiol (Mosk). 1984 Mar;29(3):20-4
Publication Type
Article
Date
Mar-1984
Author
P P Firsova
R A Kuznetsova
Source
Med Radiol (Mosk). 1984 Mar;29(3):20-4
Date
Mar-1984
Language
Russian
Publication Type
Article
Keywords
Adult
Aged
Breast Neoplasms - radiotherapy - surgery - therapy
Combined Modality Therapy
Costs and Cost Analysis
Female
Humans
Male
Middle Aged
Preoperative Care - economics
Russia
Abstract
The therapeutic, social and economic aspects of the efficacy of intense preoperative irradiation in combined therapy of breast cancer were analysed. It has been established that preoperative irradiation in the form of the fractionation of a single focal dose of 6 Gy every other day, the summary dose of 24 Gy within 8-10 days followed by surgery 1-3 days after irradiation does not either complicate its performance or the course of the postoperative period, and by the short- and long-term results it is no worse than the routine dose fractionation. Large dose fractionation saves the time of preoperative irradiation (10 days instead of 5-6 weeks), reduces the time of inpatients' stay (56-70 days instead of 90-100 days), enables most of the patients after treatment to resume work 1.2-2 mos. earlier than after the routine dose fractionation. Preoperative irradiation in the form of large dose fractionation reduces the time of treatment, does not change its efficacy and provides for a greater economic effect.
PubMed ID
6230499 View in PubMed
Less detail

[Breast cancer treated at the oncologic department, University Hospital in Tromsø 1986-94]

https://arctichealth.org/en/permalink/ahliterature21858
Source
Tidsskr Nor Laegeforen. 1997 Oct 30;117(26):3786-9
Publication Type
Article
Date
Oct-30-1997
Author
J. Norum
E. Wist
Author Affiliation
Kreftavdelingen, Regionsykehuset i Tromsø.
Source
Tidsskr Nor Laegeforen. 1997 Oct 30;117(26):3786-9
Date
Oct-30-1997
Language
Norwegian
Publication Type
Article
Keywords
Adult
Aged
Breast Neoplasms - radiotherapy - surgery - therapy
Comparative Study
Cost-Benefit Analysis
English Abstract
Female
Humans
Mastectomy - economics - methods - statistics & numerical data
Mastectomy, Modified Radical - economics - statistics & numerical data
Middle Aged
Norway
Prognosis
Quality-Adjusted Life Years
Abstract
In the period 1986 to 94, 173 women who had had a lumpectomy or a mastectomy were treated with radiotherapy at the University Hospital of Tromsø. The median diagnostic delay was 2.4 months (range 0-98.6 months). Three out of four patients were operated on within two weeks of the diagnosis being made. About two thirds experienced a delay of more than six weeks from the operation to the start of radiotherapy treatment. The five-year overall survival rate in the mastectomy and postoperative radiotherapy group was 67%. Patients with estrogen receptor positive tumours had a better prognosis. Only 5% and 7% of all patients in our region in stages I and II had breast conserving surgery (BCS) during the study period (66 patients). The five-year overall survival rate in the BCS group was 77%. BCS raised the cost per patient by about 3,000 GBP compared to modified radical mastectomy (MRM). The cost per QALY using BCS as against MRM was about 12,000 GBP. We conclude that MRM should not be used instead of BCS merely for economical reasons.
PubMed ID
9417681 View in PubMed
Less detail

Breast-conserving treatment for breast cancer in Stockholm, Sweden, 1977 to 1981.

https://arctichealth.org/en/permalink/ahliterature26792
Source
Cancer. 1984 Mar 15;53(6):1253-5
Publication Type
Article
Date
Mar-15-1984
Author
B. Cedermark
J. Askergren
A. Alveryd
U. Glas
L. Karnström
A. Somell
N O Theve
A. Wallgren
Source
Cancer. 1984 Mar 15;53(6):1253-5
Date
Mar-15-1984
Language
English
Publication Type
Article
Keywords
Adult
Aged
Breast Neoplasms - radiotherapy - surgery
Female
Follow-Up Studies
Humans
Lymph Node Excision
Mastectomy
Middle Aged
Neoplasm Recurrence, Local
Sweden
Abstract
Since 1977 patients living in Stockholm with Stage I breast cancer fulfilling specific criteria are offered breast-conserving treatment. The treatment includes a partial mastectomy and a low-axillary dissection followed by radiotherapy, 5000 rad, to the remaining breast. Between 1977 and 1981, 262 patients underwent the breast conserving therapy. One hundred eighty-six patients had pathologic Stage I tumors. Radiotherapy was given to 158 of those patients. During the follow-up time (6 months to 5 years), 4 of 186 patients had recurrence to the breast. Two of those had not received radiotherapy. Recurrent tumor in regional lymph nodes occurred in 4/186, and distant metastases in 10/186 patients. Six patients have died of their disease. The cosmetic results were favorable overall, but often impaired when surgical complications occurred. A comparison between these results and those obtained in similar patients treated with modified radical mastectomy with a low-axillar dissection followed by radiotherapy to the remaining breast seems to be an alternative treatment to modified radical mastectomy. Longer follow-up time is needed before final conclusions can be drawn.
PubMed ID
6692314 View in PubMed
Less detail

[Breast-preserving surgery in breast carcinoma. 10-year experiences]

https://arctichealth.org/en/permalink/ahliterature24884
Source
Tidsskr Nor Laegeforen. 1991 Feb 28;111(6):677-80
Publication Type
Article
Date
Feb-28-1991
Author
H. Melsom
J. Høie
Author Affiliation
Onkologisk avdeling, Det Norske Radiumhospital, Oslo.
Source
Tidsskr Nor Laegeforen. 1991 Feb 28;111(6):677-80
Date
Feb-28-1991
Language
Norwegian
Publication Type
Article
Keywords
Adult
Aged
Breast Neoplasms - radiotherapy - surgery
Carcinoma - radiotherapy - surgery
English Abstract
Evaluation Studies
Female
Follow-Up Studies
Humans
Mastectomy, Segmental - methods - standards
Middle Aged
Prognosis
Abstract
From 1979-89, 211 women with cancer mammae were irradiated at the Norwegian Radium Hospital after breast-conserving surgery performed at different hospitals in Norway. 181 of these patients were called in for re-examination to check the procedures for treatment and the cosmetic results. Only 37% of the patients had undergone mammography prior to surgery and 48% of the patients had had two or more operations before the irradiation. The cosmetic results were not very satisfactory in 45% of the patients. Reduced cosmesis was mainly due to less than optimal surgery. We propose better standardisation of the treatment programme for breast preservation. Optimal results require close collaboration between radiologists, surgeons, oncologists and pathologists. The treatment must be organized in a way that facilitates this collaboration.
PubMed ID
2008685 View in PubMed
Less detail

Castration as part of the primary treatment for operable female breast cancer. A statistical evaluation of clinical results.

https://arctichealth.org/en/permalink/ahliterature28891
Source
Acta Radiol Diagn (Stockh). 1965;:Suppl 249:1+
Publication Type
Article
Date
1965

A comparison of surgical and radiotherapy breast cancer therapy utilization in Canada (British Columbia), Scotland (Dundee), and Australia (Western Australia) with models of "optimal" therapy.

https://arctichealth.org/en/permalink/ahliterature126080
Source
Breast. 2012 Aug;21(4):570-7
Publication Type
Article
Date
Aug-2012
Author
A. Fong
J. Shafiq
C. Saunders
A M Thompson
S. Tyldesley
I A Olivotto
M B Barton
J A Dewar
S. Jacob
W. Ng
C. Speers
G P Delaney
Author Affiliation
Collaboration for Cancer Outcomes Research and Evaluation, Liverpool Hospital, Liverpool, NSW 1871, Australia. andrewfong@eml.cc
Source
Breast. 2012 Aug;21(4):570-7
Date
Aug-2012
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Breast Neoplasms - radiotherapy - surgery
British Columbia
Evidence-Based Medicine
Female
Guideline Adherence - statistics & numerical data
Health Care Surveys
Humans
Logistic Models
Mastectomy - standards - utilization
Middle Aged
Models, Theoretical
Physician's Practice Patterns - statistics & numerical data
Practice Guidelines as Topic
Radiotherapy, Adjuvant - standards - utilization
Registries
Scotland
Western Australia
Abstract
Different jurisdictions report different breast cancer treatment rates. Evidence-based utilization models may be specific to derived populations. We compared predicted optimal with actual radiotherapy utilization in British Columbia, Canada; Dundee, Scotland; and Perth, Western Australia.
Data were analyzed for differences in demography, tumor, and treatment. Epidemiological data were fitted to published Australian optimal radiotherapy utilization trees and region-specific optimal treatment rates were calculated. Optimal and actual surgery/radiotherapy rates from 2 population-based and 1 institution-based registries were compared for patients diagnosed with breast cancer between 2000 and 2004, and 2002 for British Columbia.
Mastectomy rates differed between British Columbia (40%), Western Australia (44%), and Dundee (47%, p
PubMed ID
22425535 View in PubMed
Less detail

[Conservative surgery of breast cancer. Is there a therapeutic alternative also in Norway?]

https://arctichealth.org/en/permalink/ahliterature26733
Source
Tidsskr Nor Laegeforen. 1984 Aug 10;104(22):1387-9
Publication Type
Article
Date
Aug-10-1984

34 records – page 1 of 4.