title: Axillary radiotherapy in conservative surgery for early-stage breast cancer (stage I and II).
abstract: BACKGROUND
  Several clinical studies analyze axillary treatment in women with early-stage breast cancer because of changes in the indication for axillary lymph node dissection. The aim of the study is to analyze the impact of axillary radiotherapy in disease-free and overall survival in women with early breast cancer treated with lumpectomy.
  
  
  METHODS
  Retrospective study in women with initial stages of breast carcinoma treated by lumpectomy. A comparative analysis of high-risk women with axillary lymph node involvement who received axillary radiotherapy with the group of women with low risk without radiotherapy was performed. Logistic regression was used to determine factors influencing survival and lymphedema onset.
  
  
  RESULTS
  A total of 541 women were included in the study: 384 patients (71%) without axillary lymph node involvement and 157 women (29%) with 1-3 axillary lymph node involvement. Patients with axillary radiotherapy had a higher number of metastatic lymph node compared to non-irradiated (1.6±0.7 vs. 1.4±0.6, P=.02). The group of women with axillary lymph node involvement and radiotherapy showed an overall and disease-free survival at 10 years similar to that obtained in patients without irradiation (89.7% and 77.2%, respectively). 3 lymph nodes involved multiplied by more than 7 times the risk of death (HR=7.20; 95% CI: 1.36 to 38.12). The multivariate analysis showed axillary lymph node dissection as the only variable associated with the development of lymphedema.
  
  
  CONCLUSIONS
  The incidence of axillary relapse on stage I and II breast cancer is rare. In these patients axillary radiotherapy does not improve overall survival, but contributes to regional control in those patients with risk factors.
authors.affiliation: Unidad de Mama, Servicio de Cirugía General y del Aparato Digestivo, Complejo Hospitalario Universitario de A Coruña, La Coruña, España. Electronic address: mag_1406@hotmail.com.
authors.forename: Alejandra
authors.initials: A
authors.lastname: García Novoa
authors.affiliation: Unidad de Mama, Servicio de Cirugía General y del Aparato Digestivo, Complejo Hospitalario Universitario de A Coruña, La Coruña, España.
authors.forename: Benigno
authors.initials: B
authors.lastname: Acea Nebril
authors.affiliation: Servicio de Radioterapia, Centro Oncológico de Galicia, La Coruña, España.
authors.forename: Inma
authors.initials: I
authors.lastname: Díaz
authors.affiliation: Unidad de Mama, Servicio de Cirugía General y del Aparato Digestivo, Complejo Hospitalario Universitario de A Coruña, La Coruña, España.
authors.forename: Sergio
authors.initials: S
authors.lastname: Builes Ramírez
authors.affiliation: Unidad de Mama, Servicio de Cirugía General y del Aparato Digestivo, Complejo Hospitalario Universitario de A Coruña, La Coruña, España.
authors.forename: Cristina
authors.initials: C
authors.lastname: Varela
authors.affiliation: Unidad de Mama, Servicio de Cirugía General y del Aparato Digestivo, Complejo Hospitalario Universitario de A Coruña, La Coruña, España.
authors.forename: Carmen
authors.initials: C
authors.lastname: Cereijo
authors.affiliation: Unidad de Mama, Servicio de Cirugía General y del Aparato Digestivo, Complejo Hospitalario Universitario de A Coruña, La Coruña, España.
authors.forename: Joaquín
authors.initials: J
authors.lastname: Mosquera Oses
authors.affiliation: Unidad de Estadística y Epidemiología, Complejo Hospitalario Universitario de A Coruña, La Coruña, España.
authors.forename: Beatriz
authors.initials: B
authors.lastname: López Calviño
authors.affiliation: Unidad de Estadística y Epidemiología, Complejo Hospitalario Universitario de A Coruña, La Coruña, España.
authors.forename: María Teresa
authors.initials: MT
authors.lastname: Seoane Pillado
mesh_terms: D000465:Algorithms; D001365:Axilla / Q000528:radiation effects; D001943:Breast Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D018270:Carcinoma, Ductal, Breast / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D015412:Mastectomy, Segmental; D008875:Middle Aged; D009367:Neoplasm Staging; D012189:Retrospective Studies; D015996:Survival Rate
keywords: Axillary lymph node dissection; Axillary radiotherapy; Axillary relapse; Breast cancer; Breast conserving surgery; Cirugía conservadora; Cáncer de mama; Linfadenectomía axilar; Radioterapia axilar; Recidiva axilar