title: Is there a cause-specific survival benefit of postmastectomy radiation therapy in women younger than age 50 with T3N0 invasive breast cancer? A SEER database analysis: outcomes by receptor status/race/age: analysis using the NCI Surveillance, Epidemiology, and End Results (SEER) database.
abstract: OBJECTIVE
  Postmastectomy radiation therapy (PMRT) remains controversial for patients with pathologic stage T3N0 (pT3N0) breast cancer. A Surveillance, Epidemiology, and End Results (SEER) database analysis suggested that PMRT might benefit patients older than age 50. However, the relevance between estrogen receptor (ER), progesterone receptor (PR), race, and PMRT in patients younger than age 50 is unknown.
  
  
  METHODS
  The impact of PMRT treatment on cause-specific survival (CSS) and overall survival (OS) were analyzed for women in the SEER database from 1998 to 2007. Approximately half (47%) of the 1104 patients who met the study requirements received PMRT. We performed univariate analysis to compare CSS between the PMRT and no-PMRT groups for all patients and further stratified by age, race, tumor size, tumor grade, and ER/PR status.
  
  
  RESULTS
  No difference in CSS or OS was detected between women treated with or without PMRT. Black/other race, ER-, and PR-, all suggested a trend toward decreased CSS. In univariate analysis, PMRT seems to be beneficial in patients younger than age 40 (hazard ratio=0.65; P=0.25; a nonsignificant trend in favor of PMRT).
  
  
  CONCLUSIONS
  This SEER database analysis of patients younger than age 50 and with pT3N0 breast cancer showed that PMRT did not significantly affect CSS at 5 years; however, it implied a trend of benefit for patients younger than 40. The findings that patients with African heritage and negative ER/PR status showing decreased CSS warrant further investigation to determine the role of personalized PMRT in these high-risk cohorts.
authors.affiliation: *Weill Cornell Medical College †New York Hospital Medical Center of Queens, New York, NY.
authors.forename: Weisi
authors.initials: W
authors.lastname: Yan
authors.forename: Paul
authors.initials: P
authors.lastname: Christos
authors.forename: Dattatreyudu
authors.initials: D
authors.lastname: Nori
authors.forename: K S Clifford
authors.initials: KS
authors.lastname: Chao
authors.forename: Akkamma
authors.initials: A
authors.lastname: Ravi
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000453:epidemiology / Q000208:ethnology / Q000401:mortality* / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D005260:Female; D006801:Humans; D008408:Mastectomy; D008875:Middle Aged; D011960:Receptors, Estrogen / Q000378:metabolism; D011980:Receptors, Progesterone / Q000378:metabolism; D018426:SEER Program; D015996:Survival Rate; D014481:United States
chemical_list: D011960:Receptors, Estrogen; D011980:Receptors, Progesterone