Adjuvant Radiation and Endocrine Therapy in Early-Stage Breast Cancer With Low Genomic Risk

Is omission of adjuvant radiotherapy (RT) or endocrine therapy (ET) associated with higher locoregional recurrence (LRR) rates among patients with early-stage breast cancer and low genomic risk?In this cohort study of 2249 patients aged 50 to 69 years with early-stage, hormone receptor–positive breast cancer and an Oncotype DX score of 18 or below, patients receiving RT had the lowest 72-month estimated LRR regardless of ET duration, followed by patients receiving ET alone. Patients who did not complete any adjuvant therapy had the highest LRR.These findings suggest that adjuvant RT or ET can significantly reduce the risk of LRR among patients with early-stage breast cancer and low genomic risk; de-escalated adjuvant therapy may yield acceptable outcomes for such patients, yet shared decision-making remains important as each treatment modality offers its own risks among modest benefits.

Corresponding Author: Lior Z. Braunstein, MD, Memorial Sloan Kettering Cancer Center, 1275 York Ave, Box 22, New York, NY 10065 (BraunstL@mskcc.org).

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