Research on the cutoff tumor size of omitting radiotherapy for BCSS after breast conserving surgery in women aged 65 years or oder with low-risk invasive breast carcinoma: Results based on the SEER database
Zejian Yang,
Kunlong Li,
Pei Qiu,
Yifei Ma,
Bin Wang,
Yu Yan,
Du Meng,
Chen Feng,
Yu Ren,
Yijun Li,
Pingping Li,
Can Zhou
Affiliations
Zejian Yang
Department of Breast Surgery, First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta Western Rd., Xi'an, 710061, Shaanxi Province, China; Xi'an Jiaotong University Health Science Center, 76 Yanta Western Rd., Xi'an, 710061, Shaanxi Province, China
Kunlong Li
Department of Breast Surgery, First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta Western Rd., Xi'an, 710061, Shaanxi Province, China; Xi'an Jiaotong University Health Science Center, 76 Yanta Western Rd., Xi'an, 710061, Shaanxi Province, China
Pei Qiu
Department of Breast Surgery, First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta Western Rd., Xi'an, 710061, Shaanxi Province, China; Xi'an Jiaotong University Health Science Center, 76 Yanta Western Rd., Xi'an, 710061, Shaanxi Province, China
Yifei Ma
Department of Breast Surgery, First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta Western Rd., Xi'an, 710061, Shaanxi Province, China; Xi'an Jiaotong University Health Science Center, 76 Yanta Western Rd., Xi'an, 710061, Shaanxi Province, China
Bin Wang
Department of Breast Surgery, First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta Western Rd., Xi'an, 710061, Shaanxi Province, China
Yu Yan
Department of Breast Surgery, First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta Western Rd., Xi'an, 710061, Shaanxi Province, China
Du Meng
Department of Radiotherapy, First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta Western Rd., Xi'an, 710061, Shaanxi Province, China
Chen Feng
Department of Translational Medicine, First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta Western Rd., Xi'an, 710061, Shaanxi Province, China; Department of Oncology, Shaanxi Provincial Corps Hospital, Xi'an, 710061, Shaan'xi Province, China
Yu Ren
Department of Breast Surgery, First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta Western Rd., Xi'an, 710061, Shaanxi Province, China
Yijun Li
Department of Breast Surgery, First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta Western Rd., Xi'an, 710061, Shaanxi Province, China; Xi'an Jiaotong University Health Science Center, 76 Yanta Western Rd., Xi'an, 710061, Shaanxi Province, China
Pingping Li
Department of Translational Medicine, First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta Western Rd., Xi'an, 710061, Shaanxi Province, China; Corresponding author. 277 Yanta Western Rd., Xi'an, 710061, Shaanxi Province, China.
Can Zhou
Department of Breast Surgery, First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta Western Rd., Xi'an, 710061, Shaanxi Province, China; Corresponding author. 277 Yanta Western Rd., Xi'an, 710061, Shaanxi Province, China.
Background: Radiotherapy after breast-conserving surgery (BCS) is not always necessary in older women staged T1N0M0 with low-risk invasive breast cancer, but few studies have concluded the detailed tumor size as a reference for avoiding radiotherapy. The study was conducted to explore and identify the optimal cutoff tumor size. Methods: The study population was from the Surveillance, Epidemiology, and End Results (SEER) database in 2010–2016. Propensity score matching was used to balance the confounders between groups. Predictors associated with survival were analyzed by Kaplan–Meier, X-tile, Cox proportional hazards model and competing risk model. Results: A total of 52049 women and 3846 deaths were included in the cohort with a median follow-up of 34 months. Based on the cutoff value determined by X-tile analysis, the study population were divided into small tumor group (≤14 mm in diameter) and large tumor group (>14 mm in diameter). Small tumors and radiotherapy were correlated with better breast cancer-specific survival (BCSS). In subgroup analysis, the absolute benefit of BCSS in 6 years attributed to radiotherapy was only 0.90% (RT vs. non- RT:98.77% vs. 97.87%) for patients with small tumors but up to 3.33% (RT vs. non- RT:97.10% vs. 93.77%) for those with large tumors. Conclusion: Small tumors and adjuvant radiotherapy were associated with improved long-term prognosis, and 14 mm in diameter was the cutoff tumor size of omitting radiotherapy for patients aged 65 or older with T1N0M0 stage, ER+ and HER2-breast carcinoma after BCS.
