アカシ サダコ   AKASHI Sadako
  明石 定子
   所属   医学部 医学科(東京女子医科大学病院)
   職種   教授・基幹分野長
論文種別 原著
言語種別 英語
査読の有無 査読あり
表題 A prospective analysis of two studies that used the 5-mm interval slices and 5-mm margin-free method for ipsilateral breast tumor recurrence after breast-conserving surgery without radiotherapy.
掲載誌名 正式名:Breast cancer (Tokyo, Japan)
略  称:Breast Cancer
ISSNコード:18804233/13406868
掲載区分国外
巻・号・頁 30(1),pp.131-138
著者・共著者 Ohsumi Shozo, Nishimura Reiki, Masuda Norikazu, Akashi-Tanaka Sadako, Suemasu Kimito, Yamauchi Hideko, Tokunaga Eriko, Ikeda Tadashi, Nishi Tsunehiro, Hayashi Hiroto, Iino Yuichi, Takatsuka Yuichi, Ohashi Yasuo, Inaji Hideo
発行年月 2023/01
概要 BACKGROUND:Breast-conserving surgery with radiotherapy is one of standard treatments for early breast cancer. However, it is regarded as an option to treat elderly patients with small hormone receptor-positive breast cancer with breast-conserving surgery and hormone therapy without radiotherapy. We conducted two sequential prospective studies to examine the feasibility of breast-conserving surgery without radiotherapy since 2002 and present the results.PATIENTS AND METHODS:Primary female breast cancer patients who fulfilled the strict eligibility criteria were prospectively enrolled in two sequential studies named WORTH 1 and 2. The surgical materials were sliced in 5-mm intervals and all slices were examined microscopically. Postoperative radiotherapy was not allowed, but tamoxifen or anastrozole was administered for 5 years. Ipsilateral breast tumor recurrence (IBTR)-free survival was the primary outcome.RESULTS:The data of the two studies were combined (N = 321). The median follow-up period for IBTR was 94 months (4-192 months). Only three patients were treated with adjuvant chemotherapy. The 5- and 10-year IBTR-free rates were 97.0% and 90.5%, respectively. The age at operation and PR status affected IBTR rates independently. When we calculated IBTR-free rates of patients who were 65 years of age or older at the time of surgery and had PR-positive tumors, the 5- and 10-year IBTR rates were both 98.4%.CONCLUSIONS: Our "5-mm-thick slice and 5-mm free-margin" method may be effective to select patients who can be treated by breast-conserving surgery and hormone therapy without radiotherapy.
DOI 10.1007/s12282-022-01406-5
PMID 36175750