Predictors of the risk of fibrosis at 10 years after breast conserving therapy for early breast cancer: a study based on the EORTC Trial 22881-10882 'boost versus no boost'

Eur J Cancer. 2008 Nov;44(17):2587-99. doi: 10.1016/j.ejca.2008.07.032. Epub 2008 Aug 29.

Abstract

The EORTC 22881-10882 trial in 5178 conservatively treated early breast cancer patients showed that a 16 Gy boost dose significantly improved local control, but increased the risk of breast fibrosis. To investigate predictors for the long-term risk of fibrosis, Cox regression models of the time to moderate or severe fibrosis were developed on a random set of 1797 patients with and 1827 patients without a boost, and validated in the remaining set. The median follow-up was 10.7 years. The risk of fibrosis significantly increased (P<0.01) with increasing maximum whole breast irradiation (WBI) dose and with concomitant chemotherapy, but was independent of age. In the boost arm, the risk further increased (P<0.01) if patients had post-operative breast oedema or haematoma, but it decreased (P<0.01) if WBI was given with >6 MV photons. The c-index was around 0.62. Nomograms with these factors are proposed to forecast the long-term risk of moderate or severe fibrosis.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Breast / pathology*
  • Breast Neoplasms / drug therapy
  • Breast Neoplasms / radiotherapy
  • Breast Neoplasms / surgery*
  • Combined Modality Therapy
  • Early Diagnosis
  • Fibrosis / etiology
  • Humans
  • Lymphatic Metastasis
  • Mastectomy, Segmental
  • Menopause
  • Middle Aged
  • Multivariate Analysis
  • Postoperative Complications / etiology*
  • Radiotherapy Dosage
  • Receptors, Estrogen / metabolism
  • Risk Factors

Substances

  • Receptors, Estrogen