title: Present-day locoregional control in patients with t1 or t2 breast cancer with 0 and 1 to 3 positive lymph nodes after mastectomy without radiotherapy.
abstract: BACKGROUND
  We sought to determine present-day locoregional recurrence (LRR) rates to better understand the role of postmastectomy radiotherapy (PMRT) in women with 0 to 3 positive lymph nodes.
  
  
  METHODS
  Clinical and pathologic factors were identified for 1019 patients with pT1 or pT2 tumors and 0 (n = 753), 1 (n = 176), 2 (n = 69), or 3 (n = 21) positive lymph nodes treated with mastectomy without PMRT during 1997 to 2002. Total LRR rates were calculated by Kaplan-Meier analysis and compared between subgroups by the log rank test.
  
  
  RESULTS
  After a median follow-up of 7.47 years, the overall 10-year LRR rate was 2.7%. The only independent predictor of LRR was younger age (P = 0.004). Patients ≤40 years old had a 10-year LRR rate of 11.3 vs. 1.5% for older patients (P < 0.0001). The 10-year rate of LRR in patients with 1 to 3 positive nodes was 4.3% (94.4% had systemic therapy), which was not significantly different from the 10-year risk of contralateral breast cancer development (6.5%; P > 0.5). Compared with the 10-year LRR rate among patients with node-negative disease (2.1%), patients with 1 positive node had a similar 10-year LRR risk (3.3%; P > 0.5), and patients with 2 positive nodes had a 10-year LRR risk of 7.9% (P = 0.0003). Patients with T2 tumors with 1 to 3 positive nodes had a 10-year LRR rate of 9.7%.
  
  
  CONCLUSIONS
  In patients with T1 and T2 breast cancer with 0 to 3 positive nodes, LRR rates after mastectomy are low, with the exception of patients ≤40 years old. The indications for PMRT in patients treated in the current era should be reexamined.
authors.affiliation: Department of Surgical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, TX, USA.
authors.forename: Ranjna
authors.initials: R
authors.lastname: Sharma
authors.forename: Isabelle
authors.initials: I
authors.lastname: Bedrosian
authors.forename: Anthony
authors.initials: A
authors.lastname: Lucci
authors.forename: Rosa F
authors.initials: RF
authors.lastname: Hwang
authors.forename: Loren L
authors.initials: LL
authors.lastname: Rourke
authors.forename: Wei
authors.initials: W
authors.lastname: Qiao
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Buchholz
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Kronowitz
authors.forename: Savitri
authors.initials: S
authors.lastname: Krishnamurthy
authors.forename: Gildy V
authors.initials: GV
authors.lastname: Babiera
authors.forename: Ana M
authors.initials: AM
authors.lastname: Gonzalez-Angulo
authors.forename: Funda
authors.initials: F
authors.lastname: Meric-Bernstam
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Mittendorf
authors.forename: Kelly K
authors.initials: KK
authors.lastname: Hunt
authors.forename: Henry M
authors.initials: HM
authors.lastname: Kuerer
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001365:Axilla; D001943:Breast Neoplasms / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008408:Mastectomy; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control*; D009367:Neoplasm Staging; D012189:Retrospective Studies