ESTRO Multidisciplinary Management of Breast Cancer 2017

Impact of chemotherapy on local recurrence

• NSABP B13, methotrexate plus 5FU versus no chemotherapy, LRR dropped from 13% to 2.6%.

• Housami meta-analysis was not able to look at positive margins corrected for chemotherapy or trastuzumab. Most

studies with adequate follow up predated use of trastuzumab.

• Most chemotherapy RCTs specify adequate surgery with clear margins