Evidence map›Paper›PMID 31451977›Full record

ArticleBreast cancer research and treatment2019

Effectiveness of radiotherapy after breast-conserving surgery in older patients with T1-2N0 breast cancer.

Anna Z de Boer, Esther Bastiaannet, Nienke A de Glas, Perla J Marang-van de Mheen, Olaf M Dekkers, Sabine Siesling, Linda de Munck, Kelly M de Ligt, Johanneke E A Portielje, Gerrit Jan Liefers

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Breast cancer research and treatment, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
0.7field-weighted citation impact, top 36% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it, 14 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Review
  4. Clinical and translational radiation oncology · 2021
    Article
  5. Article
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 2 institutions in 1 country.

Anna Z de BoerDepartment of Surgery, Leiden University Medical Center, Location J10-71, Postzone K6-R, P.O. Box 9600, 2300 RC, Leiden, The Netherlands. a.z.de_boer@lumc.nl.ORCID http://orcid.org/0000-0002-4413-5308
Esther BastiaannetDepartment of Surgery, Leiden University Medical Center, Location J10-71, Postzone K6-R, P.O. Box 9600, 2300 RC, Leiden, The Netherlands.
Nienke A de GlasDepartment of Medical Oncology, Leiden University Medical Center, Leiden, The Netherlands.
Perla J Marang-van de MheenDepartment of Medical Decision-Making, Leiden University Medical Center, Leiden, The Netherlands.
Olaf M DekkersDepartment of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands.
Sabine SieslingDepartment of Research and Development, Netherlands Comprehensive Cancer Organisation, Utrecht, The Netherlands.
Linda de MunckDepartment of Research and Development, Netherlands Comprehensive Cancer Organisation, Utrecht, The Netherlands.
Kelly M de LigtDepartment of Research and Development, Netherlands Comprehensive Cancer Organisation, Utrecht, The Netherlands.
Johanneke E A PortieljeDepartment of Medical Oncology, Leiden University Medical Center, Leiden, The Netherlands.
Gerrit Jan LiefersDepartment of Surgery, Leiden University Medical Center, Location J10-71, Postzone K6-R, P.O. Box 9600, 2300 RC, Leiden, The Netherlands.
Leiden University Medical Center · NLNetherlands Comprehensive Cancer Organisation · NL

Funding

ZonMw 843002623
6 · The paper itself

Abstract

purposeIn the Netherlands, radiotherapy after breast-conserving surgery (BCS) is omitted in up to 30% of patients aged ≥ 75 years. Although omission of radiotherapy is considered an option for older women treated with endocrine treatment, the majority of these patients do not receive systemic treatment following Dutch treatment guidelines. Therefore, the aim of this study was to evaluate the effect of omission of radiotherapy on locoregional recurrence risk in this patient population.

methodsPatients aged ≥ 75 years undergone BCS for T1-2N0 breast cancer diagnosed between 2003 and 2009 were selected from the Netherlands Cancer Registry. To minimize confounding by indication, hospital variation was used to assess the impact of radiotherapy-use on locoregional recurrence risk using cox proportional hazards regression. Hazards ratios with 95% confidence interval (CI) were estimated.

resultsOverall, 2390 patients were included. Of the patients with hormone receptor-positive breast cancer, 39.3% received endocrine treatment. Five-year incidences of locoregional recurrence were 1.9%, 2.8%, and 3.0% in patients treated at hospitals with higher (average radiotherapy-use 96.0%), moderate (88.0%), and lower radiotherapy-use (72.2%) respectively, and nine-year incidences were 2.2%, 3.1%, and 3.2% respectively. Adjusted hazard ratios were 1.46 (95% CI 0.77-2.78) and 1.50 (95% CI 0.79-2.85) for patients treated at hospitals with moderate and lower radiotherapy-use, compared to patient treated at hospitals with higher radiotherapy-use.

conclusionsDespite endocrine treatment in only 39.3%, locoregional recurrence risk was low, even in patients treated at hospitals with lower radiotherapy-use. This provides reasonable grounds to consider omission of radiotherapy in patients aged ≥ 75 years with T1-2N0 breast cancer.

Indexed as

AgedAged, 80 and overBreast NeoplasmsFemaleHospitalsHumansIncidenceMastectomy, SegmentalNeoplasm Recurrence, LocalNeoplasm StagingNetherlandsProportional Hazards ModelsRadiotherapy, AdjuvantRegistriesBreast cancerBreast-conserving treatmentLocoregional recurrenceOlder patients

Identifiers

PMID31451977
PMCPMC6817758
OpenAlexW2970164388

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.