Can Less Be More for Individuals With Low-Risk Breast Cancer?
Menée à partir des données de 7 essais portant sur 1 778 patientes traitées par lumpectomie et hormonothérapie pour un cancer hormonosensible du sein de stade précoce et à faible risque de récidive, cette étude évalue l'association entre l'absence de radiothérapie adjuvante et le risque de récidive, la survie spécifique ou la survie globale
Steady progress in reducing mortality from breast cancer is a testament to the benefits of randomized clinical trials, multidisciplinary collaborations, and data sharing. In the second half of the last century, surgical, medical, and radiation oncologists worked together to methodically and rigorously test de-escalating surgical interventions and include multimodality treatment approaches to reduce local and distant breast cancer recurrence (1,2). The stepwise approach led to abandoning the disfiguring radical mastectomy, giving women the choice of simple mastectomy or breast conservation, and providing guidance on the benefits and risks of adjuvant hormonal and systemic chemotherapy. Over the years, improvements in screening technology, uptake of screening, along with improved prognostic characterization of breast cancer, have identified subgroups of patients with low risk for recurrence. For those low-risk patients, the question becomes how much treatment is enough to reduce both risk of recurrence and adverse effects of treatment?
Journal of the National Cancer Institute , commentaire en libre accès, 2017