SABCS 2022: Breast-Conserving Therapy May Benefit Some Patients With Multiple Ipsilateral Breast Cancer

By: Julia Fiederlein Cipriano
Posted: Wednesday, December 21, 2022

Data are limited regarding the oncologic safety of breast-conserving therapy for multiple ipsilateral breast cancer. The results of the phase II ACOSOG Z11102 (Alliance) trial, which were presented by Judy C. Boughey, MD, of the Mayo Clinic, Rochester, Minnesota, and colleagues revealed an “acceptably low” rate of local recurrence in this setting during the 2022 San Antonio Breast Cancer Symposium (SABCS; Abstract GS4-01).

“This study provides important information for clinicians to discuss with patients who have two or three foci of breast cancer in one breast, as it may allow more patients to consider breast-conserving therapy as an option,” commented Dr. Boughey in a press release from the American Association for Cancer Research. “Lumpectomy with radiation therapy is often preferred to mastectomy, as it is a smaller operation with quicker recovery, resulting in better patient satisfaction and cosmetic outcomes.”

A total of 194 eligible patients with two or three foci of biopsy-proven breast cancer completed breast-conserving surgery with adjuvant radiation therapy and lumpectomy site boosts. At a median follow-up of 66.6 months, six patients developed a local recurrence; this corresponds to an estimated cumulative incidence of local recurrence of 3.2% at 5 years. Although no patients developed regional or local and distant recurrence, five developed distant recurrence, five developed contralateral breast cancer, three developed new primary tumors not in the breast, and eight died (including one related to breast cancer).

The 5-year rate of local recurrence was lower among the 180 patients who underwent a preoperative breast MRI compared with the 14 patients who did not undergo this imaging (1.7% vs. 22.6%; P = .002). The risk of local recurrence was not found to be significantly associated with age, the number of breast lesions, HER2 status, or pathologic staging category.

Disclosure: For full disclosures of the study authors, visit sabcs.org.

2022 San Antonio Breast Cancer Symposium

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