HER2 Support Group Forums - View Single Post - Question answered for the first time! Do her2+ breast cancers recur more often after

Lani · 09-05-2006, 06:24 PM

and found articles showing higher recurrence rates for those <40 yrs old and decreasing with patients' age

Among other articles I came across this one again, which I had pointed out to Tom in case it could provide some solice. It shows at least that they are reexamining another long-held dogmatic position (perhaps rightly, perhaps wrongly, but at least they were reevaluating it!):

Int J Radiat Oncol Biol Phys. 2006 Aug 1;65(5):1416-21. Epub 2006 May 26. Links
Re-excision of margins before breast radiation-diagnostic or therapeutic?

Chism DB,
Freedman GM,
Li T,
Anderson PR.
Department of Radiation Oncology, North Shore Medical Center, Peabody, MA, USA.
PURPOSE: To identify factors in breast cancer patients that predict the pathologic results of re-excision for close or positive margins and to determine the effect on local control. METHODS AND MATERIALS: We divided 1,044 patients with Stage I-II breast cancer with a close (< or =2 mm) or positive margin after initial excision into three groups. Group 1 included 199 patients without additional excision, Group 2 included 546 patients with re-excision found to be free of cancer, and Group 3 included 299 patients with re-excision and residual cancer. All patients were treated with radiotherapy with a median follow-up of 6.7 years. RESULTS: The 10-year local control rate was 95% for Group 1 and 94% for Groups 2 and 3 (p = 0.788). Of the 846 patients, 65% had no residual disease on re-excision and 35% did have residual tumor. The factors significantly associated with positive re-excision findings were initial positive margins, positive nodes, Stage T2 tumor, and an extensive intraductal component. The 10-year local control rate was 95% for Group 2 vs. 91% for Group 3 (p = 0.038). CONCLUSION: The low recurrence rates seen in this study suggest that selected patients with non-negative margins, particularly those with a low risk of having residual disease at re-excision, may be treated with radiotherapy.
PMID: 16730133 [PubMed - in process]

Again, this does not differentiate by her2 status, age or LVI. Until such studies are done, we will be lumping the whole "fruit salad" together instead of discussing apples vs oranges vs plums.

09-05-2006, 06:24 PM	#5
Lani Senior Member Join Date: Mar 2006 Posts: 4,778	Becky, I had been researching recurrence rates for an 84 year old and found articles showing higher recurrence rates for those <40 yrs old and decreasing with patients' age Among other articles I came across this one again, which I had pointed out to Tom in case it could provide some solice. It shows at least that they are reexamining another long-held dogmatic position (perhaps rightly, perhaps wrongly, but at least they were reevaluating it!): Int J Radiat Oncol Biol Phys. 2006 Aug 1;65(5):1416-21. Epub 2006 May 26. Links Re-excision of margins before breast radiation-diagnostic or therapeutic? Chism DB, Freedman GM, Li T, Anderson PR. Department of Radiation Oncology, North Shore Medical Center, Peabody, MA, USA. PURPOSE: To identify factors in breast cancer patients that predict the pathologic results of re-excision for close or positive margins and to determine the effect on local control. METHODS AND MATERIALS: We divided 1,044 patients with Stage I-II breast cancer with a close (< or =2 mm) or positive margin after initial excision into three groups. Group 1 included 199 patients without additional excision, Group 2 included 546 patients with re-excision found to be free of cancer, and Group 3 included 299 patients with re-excision and residual cancer. All patients were treated with radiotherapy with a median follow-up of 6.7 years. RESULTS: The 10-year local control rate was 95% for Group 1 and 94% for Groups 2 and 3 (p = 0.788). Of the 846 patients, 65% had no residual disease on re-excision and 35% did have residual tumor. The factors significantly associated with positive re-excision findings were initial positive margins, positive nodes, Stage T2 tumor, and an extensive intraductal component. The 10-year local control rate was 95% for Group 2 vs. 91% for Group 3 (p = 0.038). CONCLUSION: The low recurrence rates seen in this study suggest that selected patients with non-negative margins, particularly those with a low risk of having residual disease at re-excision, may be treated with radiotherapy. PMID: 16730133 [PubMed - in process] Again, this does not differentiate by her2 status, age or LVI. Until such studies are done, we will be lumping the whole "fruit salad" together instead of discussing apples vs oranges vs plums.