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Omitting radiotherapy after breast-conserving surgery is safe for certain patients with breast cancer, according to researchers.
The researchers found evidence to suggest that radiotherapy could be omitted in patients who were 55 years or older and had T1N0, grade 1-2, luminal A breast cancer.
These results, from the LUMINA study (ClinicalTrials.gov Identifier: NCT01791829), were published in The New England Journal of Medicine.
The study included 500 patients who were 55 years of age or older (median, 67.1 years). They had undergone breast-conserving surgery for T1N0, grade 1-2, luminal A breast cancer and had received adjuvant endocrine therapy.
At 5 years, the cumulative incidence of local recurrence in these patients was 2.3%. All 10 local recurrences were invasive, 6 were true or marginal recurrences, and 4 happened elsewhere in the ipsilateral breast.
There were 12 recurrences overall (2 distant in addition to the 10 local), making the cumulative incidence of recurrence at 5 years 2.7%.
In addition, there were 8 contralateral breast cancers (all invasive), for a cumulative incidence of 1.9%.
The 5-year disease-free survival rate was 89.9%, and the overall survival rate was 97.2%.
“Our study showed that women 55 years of age or older with T1N0, grade 1 or 2, luminal A breast cancer had a very low risk of local recurrence at 5 years after breast-conserving surgery when treated with endocrine therapy alone,” the researchers concluded. “The prospective and controlled nature of this study supports our conclusion that such patients are candidates for omission of radiotherapy.”
Disclosures: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.
Reference
Whelan TJ, Smith S, Parpia S, et al. Omitting radiotherapy after breast-conserving surgery in luminal A breast cancer. N Engl J Med. Published August 17, 2023. doi:10.1056/NEJMoa2302344
This article originally appeared on Cancer Therapy Advisor
