Breast Cancer Research and Treatment

, Volume 130, Issue 1, pp 353–355 | Cite as

Re Panoff et al., Risk of locoregional recurrence by receptor status in breast cancer patients receiving modern systemic therapy and post-mastectomy radiation

  • Peter Graham
Letter to the Editor

To the Editor,

We were pleased to see Panoff et al.’s observations of excellent locoregional control [1]. Modern targeted systemic therapy for HER2 positive tumours seems to have made a positive impact with locoregional recurrence of only 1.7 and 6.2% in the overall population. We would, however, note that appropriate targeting of HER2 positive patients could only reduce expected recurrence in 23% of patients and this alone cannot explain the excellent results overall, since ER positive tumours have been routinely treated with anti-oestrogen therapy for decades. We note that over 90% of patients had a dose of 60 Gy to the chest wall which is higher than most adjuvant post-mastectomy trials. In addition, the higher dose of radiation halved local recurrence, which is consistent with the effect seen in breast conservation randomised trials of a boost dose of radiotherapy [2]. Since chest wall recurrence accounts for approximately 70% of locoregional recurrence and this intervention...


Trastuzumab Systemic Therapy Locoregional Recurrence HER2 Positive Patient Triple Negative Phenotype 
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Conflict of interest



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    Panoff JE, Hrely J, Takita C, Reis IM, Zhao W, Sujoy V, Gomez CR, Jorda M, Koniaris I, Wright JL (2011) Risk of locoregional recurrence by receptor status in breast cancer patients receiving modern systemic therapy and post-mastectomy radiation. Breast Cancer Res Treat. doi: 10.1007/s10549-011-1495-1
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References for Rebuttal letter

  1. 1.
    Panoff JE, Takita C, Hurley J et al (2011) Higher chest wall dose results in improved locoregional outcome in patients receiving postmastectomy radiation. Int J Radiat Oncol Biol Phys [Epub ahead of print]Google Scholar

Copyright information

© Springer Science+Business Media, LLC. 2011

Authors and Affiliations

  1. 1.Cancer Care CentreSt George HospitalKogarahAustralia

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