Digitale Medien
Oxford, UK
:
Blackwell Science Inc
The @breast journal
9 (2003), S. 0
ISSN:
1524-4741
Quelle:
Blackwell Publishing Journal Backfiles 1879-2005
Thema:
Medizin
Notizen:
Abstract: Radiation therapy is clearly established as a modality that can lower the risk of local recurrence following breast-conserving surgery for early stage invasive breast cancer. Numerous prognostic factors are known to influence the risk of local recurrence, including the size and histology of the primary tumor. An extensive intraductal component can also increase risk, although this seems to be the case only with close or focally involved surgical margins. Whether or not there is any subset of patients for whom radiation can be omitted has been studied through retrospective analyses of randomized trials and even through a prospective trial. No clear subset of patients has emerged, although in older patients receiving tamoxifen, very low recurrence rates have been observed with and without radiation in recently reported studies with relatively short follow-up. For recurrence following excision of ductal carcinoma in situ (DCIS), all subsets also seem to benefit from radiation, based on data from randomized trials, and there are currently prospective trials assessing the strategy of omitting radiation therapy for lower-risk lesions. Since tamoxifen can also reduce the risk of local recurrence, this treatment has been included in the radiation-sparing trials. The use of postmastectomy radiation has been shown to lower distant recurrence and mortality risk in Danish and Canadian studies involving node-positive cases. Given the very high local recurrence rates seen in the control arm, a large randomized trial in the United States is assessing the role of postmastectomy radiation for one to three involved nodes.
Materialart:
Digitale Medien
URL:
http://dx.doi.org/10.1046/j.1524-4741.9.s1.3.x
|
Standort |
Signatur |
Einschränkungen |
Verfügbarkeit |
