• Richard Pötter, Michael Gnant, Werner Kwasny, Christoph Tausch, Leonore Handl-Zeller, Brigitte Pakisch, Susanne Taucher, Josef Hammer, Gero Luschin-Ebengreuth, Marianne Schmid, Felix Sedlmayer, Michael Stierer, Georg Reiner, Karin Kapp, Friedrich Hofbauer, Andrea Rottenfusser, Sabine Pöstlberger, Karin Haider, Wolfgang Draxler, Raimund Jakesz, and Austrian Breast and Colorectal Cancer Study Group.
• Department of Surgery, Medical University of Vienna, Vienna, Austria. Richard.Poetter@meduniwien.ac.at
• Int. J. Radiat. Oncol. Biol. Phys. 2007 Jun 1; 68 (2): 334-40.

PurposeIn women with favorable early breast cancer treated by lumpectomy plus tamoxifen or anastrazole, it remains unclear whether whole breast radiotherapy is beneficial.Methods And MaterialBetween January 1996 and June 2004, the Austrian Breast and Colorectal Cancer Study Group (ABCSG) randomly assigned 869 women to receive breast radiotherapy +/- boost (n = 414) or not (n = 417) after breast-conserving surgery (ABCSG Study 8A). Favorable early breast cancer was specified as tumor size <3 cm, Grading 1 or 2, negative lymph nodes, positive estrogen and/or progesterone receptor status, and manageable by breast-conserving surgery. Breast radiotherapy was performed after lumpectomy with 2 tangential opposed breast fields with mean 50 Gy, plus boost in 71% of patients with mean 10 Gy, in a median of 6 weeks. The primary endpoint was local relapse-free survival; further endpoints were contralateral breast cancer, distant metastases, and disease-free and overall survival. The median follow-up was 53.8 months.ResultsThe mean age was 66 years. Overall, there were 21 local relapses, with 2 relapses in the radiotherapy group (5-y rate 0.4%) vs. 19 in the no-radiotherapy group (5.1%), respectively (p = 0.0001, hazard ratio 10.2). Overall relapses occurred in 30 patients, with 7 events in the radiotherapy group (5-y rate 2.1%) vs. 23 events in the no-radiotherapy group (6.1%) (p = 0.002, hazard ratio 3.5). No significant differences were found for distant metastases and overall survival.ConclusionBreast radiotherapy +/- boost in women with favorable early breast cancer after lumpectomy combined with tamoxifen/anastrazole leads to a significant reduction in local and overall relapse.

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