Open Access
Open access
Ovid Technologies (Wolters Kluwer Health)
Medicine (United States)
,  volume 104 ,  issue 8 ,  pages e41632

Adjuvant radiotherapy in postmenopausal women with early-stage ER-positive breast cancer: A systematic review and meta-analysis

Amira M. Taha 1
, 
Hanaa Abdelmoneim Kamel 2
, 
Yehya Khlidj 3
, 
Dalal Salama Salem 4
, 
Sara Adel Abdelkader Saed 5
, 
Khaled Abouelmagd 6
, 
Dang Nguyen 7
, 
Emad Shash 8
, 
Sanskriti Chapagain 9
, 
Loay Kassem 10
1
 
2
 
Rheumatology Department, Al Haram Hospital, Giza, Egypt | 
3
 
4
 
5
 
Department of Clinical Pharmacy, London, UK | 
6
 
7
 
8
 
9
 
Devdaha Medical College and Research Institute Pvt. Ltd, Devdaha, Rupandehi, Nepal | 
10
 
Publication type: Journal Article
Publication date: 2025-02-21
Ovid Technologies (Wolters Kluwer Health)
scimago Q3
wos Q2
SJR: 0.469
CiteScore: 2.5
Impact factor: 1.4
ISSN: 00257974, 15365964
Abstract
Background:

The management of early breast cancer (BC) includes breast-conserving surgery (BCS), postoperative radiation therapy (PORT) and systemic therapy. Therefore, we aim at evaluating all the efficacy endpoints for PORT compared to no PORT in older women with early-stage BC.

Method:

We searched PubMed, Web of Science, Cochrane, and Scopus databases from inception up to May 2024 for randomized controlled trials (RCTs) where patients were randomized into either PORT vs no PORT. The following outcomes were studied: any local recurrence, nodal recurrence, contralateral BC, distant relapse, all-causes and cancer-specific mortality.

Result:

Seven eligible RCTs with a total of 4860 patients were included; 2435 of them received PORT; and 2425 did not. All patients had a node-negative disease, with 84.4% older than 60 years and only 10.4% had tumors larger than 2 cm. Patients in both treatment arms were offered adjuvant endocrine therapy e.g. tamoxifen and anastrozole. The median follow-up was 9.7 years (95% CI: 5.1–11.3). The survival risk for any local recurrence for patients with no radiotherapy was significantly higher than for those who used PORT (HR: 6.3; 95% CI: 4.17–9.52). Also, patients in the PORT arm had a significantly lower risk of nodal recurrence (risk of recurrence (RR): 0.28, 95% CI: 0.11–0.72, P = .009). However, PORT was not associated with a significant reduction in the risk of contralateral BC, distant relapse, BC-specific mortality or all-cause mortality (RR: 0.883, 1.52, 1.12, 0.995, respectively).

Conclusion:

Postoperative radiotherapy significantly reduces local and regional recurrence following BCS in early estrogen receptor-positive elderly BC with limited value on distant recurrence or mortality. The risk-benefit ratio should be determined for every patient to avoid overtreatment of a significant proportion of patients.

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GOST |
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GOST Copy
Taha A. M. et al. Adjuvant radiotherapy in postmenopausal women with early-stage ER-positive breast cancer: A systematic review and meta-analysis // Medicine (United States). 2025. Vol. 104. No. 8. p. e41632.
GOST all authors (up to 50) Copy
Taha A. M., Kamel H. A., Khlidj Y., Salem D. S., Saed S. A. A., Abouelmagd K., Nguyen D., Shash E., Chapagain S., Kassem L. Adjuvant radiotherapy in postmenopausal women with early-stage ER-positive breast cancer: A systematic review and meta-analysis // Medicine (United States). 2025. Vol. 104. No. 8. p. e41632.
RIS |
Cite this
RIS Copy
TY - JOUR
DO - 10.1097/md.0000000000041632
UR - https://journals.lww.com/10.1097/MD.0000000000041632
TI - Adjuvant radiotherapy in postmenopausal women with early-stage ER-positive breast cancer: A systematic review and meta-analysis
T2 - Medicine (United States)
AU - Taha, Amira M.
AU - Kamel, Hanaa Abdelmoneim
AU - Khlidj, Yehya
AU - Salem, Dalal Salama
AU - Saed, Sara Adel Abdelkader
AU - Abouelmagd, Khaled
AU - Nguyen, Dang
AU - Shash, Emad
AU - Chapagain, Sanskriti
AU - Kassem, Loay
PY - 2025
DA - 2025/02/21
PB - Ovid Technologies (Wolters Kluwer Health)
SP - e41632
IS - 8
VL - 104
SN - 0025-7974
SN - 1536-5964
ER -
BibTex |
Cite this
BibTex (up to 50 authors) Copy
@article{2025_Taha,
author = {Amira M. Taha and Hanaa Abdelmoneim Kamel and Yehya Khlidj and Dalal Salama Salem and Sara Adel Abdelkader Saed and Khaled Abouelmagd and Dang Nguyen and Emad Shash and Sanskriti Chapagain and Loay Kassem},
title = {Adjuvant radiotherapy in postmenopausal women with early-stage ER-positive breast cancer: A systematic review and meta-analysis},
journal = {Medicine (United States)},
year = {2025},
volume = {104},
publisher = {Ovid Technologies (Wolters Kluwer Health)},
month = {feb},
url = {https://journals.lww.com/10.1097/MD.0000000000041632},
number = {8},
pages = {e41632},
doi = {10.1097/md.0000000000041632}
}
MLA
Cite this
MLA Copy
Taha, Amira M., et al. “Adjuvant radiotherapy in postmenopausal women with early-stage ER-positive breast cancer: A systematic review and meta-analysis.” Medicine (United States), vol. 104, no. 8, Feb. 2025, p. e41632. https://journals.lww.com/10.1097/MD.0000000000041632.