Postmastectomy Irradiation in High-Risk Breast Cancer Patients: Present status of the Danish Breast Cancer Cooperative Group trials

Authors

  • M. Overgaard Department of Oncology and Department of Radiophysics, and the Danish Cancer Society, Department of Experimental Clinical Oncology Radiumstationen Aarhus the Department of Oncology Ona and Department of Radiophysics, the Danish Breast Cancer Cooperative Group Secretariat, the Finsen Institute, Rigshospitalet, Copenhagen, and the Departments of Oncology and Radiophysics, Odense University Hospital Odense Copenhagen University Hospital Herlev County Hospital Aalborg, and County Hospital, Vejle, Denmark
  • J. Juul Christensen Department of Oncology and Department of Radiophysics, and the Danish Cancer Society, Department of Experimental Clinical Oncology Radiumstationen Aarhus the Department of Oncology Ona and Department of Radiophysics, the Danish Breast Cancer Cooperative Group Secretariat, the Finsen Institute, Rigshospitalet, Copenhagen, and the Departments of Oncology and Radiophysics, Odense University Hospital Odense Copenhagen University Hospital Herlev County Hospital Aalborg, and County Hospital, Vejle, Denmark
  • H. Johansen Department of Oncology and Department of Radiophysics, and the Danish Cancer Society, Department of Experimental Clinical Oncology Radiumstationen Aarhus the Department of Oncology Ona and Department of Radiophysics, the Danish Breast Cancer Cooperative Group Secretariat, the Finsen Institute, Rigshospitalet, Copenhagen, and the Departments of Oncology and Radiophysics, Odense University Hospital Odense Copenhagen University Hospital Herlev County Hospital Aalborg, and County Hospital, Vejle, Denmark
  • A. Nybo-Rasmussen Department of Oncology and Department of Radiophysics, and the Danish Cancer Society, Department of Experimental Clinical Oncology Radiumstationen Aarhus the Department of Oncology Ona and Department of Radiophysics, the Danish Breast Cancer Cooperative Group Secretariat, the Finsen Institute, Rigshospitalet, Copenhagen, and the Departments of Oncology and Radiophysics, Odense University Hospital Odense Copenhagen University Hospital Herlev County Hospital Aalborg, and County Hospital, Vejle, Denmark
  • H. Brincker Department of Oncology and Department of Radiophysics, and the Danish Cancer Society, Department of Experimental Clinical Oncology Radiumstationen Aarhus the Department of Oncology Ona and Department of Radiophysics, the Danish Breast Cancer Cooperative Group Secretariat, the Finsen Institute, Rigshospitalet, Copenhagen, and the Departments of Oncology and Radiophysics, Odense University Hospital Odense Copenhagen University Hospital Herlev County Hospital Aalborg, and County Hospital, Vejle, Denmark
  • P. van der Kooy Department of Oncology and Department of Radiophysics, and the Danish Cancer Society, Department of Experimental Clinical Oncology Radiumstationen Aarhus the Department of Oncology Ona and Department of Radiophysics, the Danish Breast Cancer Cooperative Group Secretariat, the Finsen Institute, Rigshospitalet, Copenhagen, and the Departments of Oncology and Radiophysics, Odense University Hospital Odense Copenhagen University Hospital Herlev County Hospital Aalborg, and County Hospital, Vejle, Denmark
  • P. L. Frederiksen Department of Oncology and Department of Radiophysics, and the Danish Cancer Society, Department of Experimental Clinical Oncology Radiumstationen Aarhus the Department of Oncology Ona and Department of Radiophysics, the Danish Breast Cancer Cooperative Group Secretariat, the Finsen Institute, Rigshospitalet, Copenhagen, and the Departments of Oncology and Radiophysics, Odense University Hospital Odense Copenhagen University Hospital Herlev County Hospital Aalborg, and County Hospital, Vejle, Denmark
  • F. Laursen Department of Oncology and Department of Radiophysics, and the Danish Cancer Society, Department of Experimental Clinical Oncology Radiumstationen Aarhus the Department of Oncology Ona and Department of Radiophysics, the Danish Breast Cancer Cooperative Group Secretariat, the Finsen Institute, Rigshospitalet, Copenhagen, and the Departments of Oncology and Radiophysics, Odense University Hospital Odense Copenhagen University Hospital Herlev County Hospital Aalborg, and County Hospital, Vejle, Denmark
  • J. Panduro Department of Oncology and Department of Radiophysics, and the Danish Cancer Society, Department of Experimental Clinical Oncology Radiumstationen Aarhus the Department of Oncology Ona and Department of Radiophysics, the Danish Breast Cancer Cooperative Group Secretariat, the Finsen Institute, Rigshospitalet, Copenhagen, and the Departments of Oncology and Radiophysics, Odense University Hospital Odense Copenhagen University Hospital Herlev County Hospital Aalborg, and County Hospital, Vejle, Denmark
  • N. E. Sørensen Department of Oncology and Department of Radiophysics, and the Danish Cancer Society, Department of Experimental Clinical Oncology Radiumstationen Aarhus the Department of Oncology Ona and Department of Radiophysics, the Danish Breast Cancer Cooperative Group Secretariat, the Finsen Institute, Rigshospitalet, Copenhagen, and the Departments of Oncology and Radiophysics, Odense University Hospital Odense Copenhagen University Hospital Herlev County Hospital Aalborg, and County Hospital, Vejle, Denmark
  • C. C. Gadeberg Department of Oncology and Department of Radiophysics, and the Danish Cancer Society, Department of Experimental Clinical Oncology Radiumstationen Aarhus the Department of Oncology Ona and Department of Radiophysics, the Danish Breast Cancer Cooperative Group Secretariat, the Finsen Institute, Rigshospitalet, Copenhagen, and the Departments of Oncology and Radiophysics, Odense University Hospital Odense Copenhagen University Hospital Herlev County Hospital Aalborg, and County Hospital, Vejle, Denmark
  • M. Hjelm-Hansen Department of Oncology and Department of Radiophysics, and the Danish Cancer Society, Department of Experimental Clinical Oncology Radiumstationen Aarhus the Department of Oncology Ona and Department of Radiophysics, the Danish Breast Cancer Cooperative Group Secretariat, the Finsen Institute, Rigshospitalet, Copenhagen, and the Departments of Oncology and Radiophysics, Odense University Hospital Odense Copenhagen University Hospital Herlev County Hospital Aalborg, and County Hospital, Vejle, Denmark
  • J. Overgaard Department of Oncology and Department of Radiophysics, and the Danish Cancer Society, Department of Experimental Clinical Oncology Radiumstationen Aarhus the Department of Oncology Ona and Department of Radiophysics, the Danish Breast Cancer Cooperative Group Secretariat, the Finsen Institute, Rigshospitalet, Copenhagen, and the Departments of Oncology and Radiophysics, Odense University Hospital Odense Copenhagen University Hospital Herlev County Hospital Aalborg, and County Hospital, Vejle, Denmark
  • K. West Andersen Department of Oncology and Department of Radiophysics, and the Danish Cancer Society, Department of Experimental Clinical Oncology Radiumstationen Aarhus the Department of Oncology Ona and Department of Radiophysics, the Danish Breast Cancer Cooperative Group Secretariat, the Finsen Institute, Rigshospitalet, Copenhagen, and the Departments of Oncology and Radiophysics, Odense University Hospital Odense Copenhagen University Hospital Herlev County Hospital Aalborg, and County Hospital, Vejle, Denmark
  • K. Zedeler Department of Oncology and Department of Radiophysics, and the Danish Cancer Society, Department of Experimental Clinical Oncology Radiumstationen Aarhus the Department of Oncology Ona and Department of Radiophysics, the Danish Breast Cancer Cooperative Group Secretariat, the Finsen Institute, Rigshospitalet, Copenhagen, and the Departments of Oncology and Radiophysics, Odense University Hospital Odense Copenhagen University Hospital Herlev County Hospital Aalborg, and County Hospital, Vejle, Denmark

DOI:

https://doi.org/10.3109/02841868809091773

Keywords:

Breast cancer, postmastectomy irradiation, locoregional recurrence, adjuvant treatment

Abstract

Abstract

All pre- and postmenopausal high-risk breast cancer patients in the protocols DBCG 77 of the Danish Breast Cancer Cooperative Group received postmastectomy irradiation before randomization to either adjuvant systemic therapy or no such treatment. The actuarial loco-regional recurrence rate at 9 years was 6–17%, with the lowest rate in patients who also received additional adjuvant chemotherapy or tamoxifen. In a subsequent study (DBCG 82) the role of postmastectomy irradiation together with systemic treatment was evaluated in high-risk patients. Pre- and menopausal patients were randomized to postmastectomy irradiation+CMF (cyclophosphamide, methotrexate, 5-fluorouracil), CMF alone or CMF+TAM (tamoxifen). Postmenopausal patients were randomized to postmastectomy irradiation+TAM, TAM or CMF+TAM. At 4 years the loco-regional recurrence rate was significantly lower in the irradiated patients (5–7% vs. 23–33%). Further, disease-free survival was significantly improved in both pre- and postmenopausal irradiated patients compared with those who had only systemic treatment. At present, there are no significant differences between survival in the treatment groups. Thus, adjuvant systemic treatment alone (chemotherapy and/or tamoxifen) did not prevent loco-regional recurrences in high-risk patients after mastectomy and axillary lymph node sampling. However, a longer observation time is necessary to evaluate the consequence of primary optimal loco-regional tumour control in high-risk breast cancer patients with respect to survival.

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Published

1988-01-01

How to Cite

Overgaard, M., Juul Christensen, J., Johansen, H., Nybo-Rasmussen, A., Brincker, H., van der Kooy, P., … Zedeler, K. (1988). Postmastectomy Irradiation in High-Risk Breast Cancer Patients: Present status of the Danish Breast Cancer Cooperative Group trials. Acta Oncologica, 27(6), 707–714. https://doi.org/10.3109/02841868809091773

Issue

Vol. 27 No. 6 (1988): Acta Oncologica

Section

Articles