Role of postmastectomy radiation therapy in breast cancer patients with T1-2 and 1-3 positive lymph nodes.
OBJECTIVE
To evaluate the role of radiotherapy (RT) in overall survival (OS) and disease-free survival in postmastectomy breast cancer patients with tumor size <5 cm, with 1-3 involved axillary lymph nodes (T1-2N1).


METHODS
We conducted a retrospective study of 89 postmastectomy patients with T1-2N1 disease between 2005 and 2015 at the Radiation Oncology Clinic of Kayseri Training and Research Hospital. Clinicopathologic, demographic, and laboratory findings, as well as treatment regimens were investigated. OS and disease-free survival as well as factors that can be valuable in the prognosis were evaluated.


RESULTS
A total of 89 female patients with an average age of 53 years (range: 30-81 years) were included in the assessment. Five-year and 10-year local recurrence rates were found to be 6.6% in the RT group and 7.1% in the non-RT group. In the RT group, the mean OS was 110.3 months and progression-free survival was 104.4 months. In the non-RT group, the corresponding figures were 104.3 months and 92.1 months, respectively. Statistically significant correlation was observed between RT and the American Joint Committee on Cancer stage (P<0.001), histological type (P=0.013), tumor size (P<0.001), and lymph node metastasis (P<0.001). During the assessment, locoregional recurrence and/or distant metastasis occurred in nine patients (10%). Locoregional recurrence was observed mostly in patients with invasive ductal carcinoma, tumor >3.0 cm in size, grade II tumors, and perinodal invasion, and who were premenopausal at the time of diagnosis.


CONCLUSIONS
In T1-2N1 breast cancer patients who underwent modified radical mastectomy, when the effects of postmastectomy RT were evaluated, there were no differences in terms of OS and progression-free survival. In addition, when subgroup analysis was made, in patients with invasive ductal carcinoma, tumor diameter >2 cm, three lymph node metastasis, and stage 2b, postmastectomy RT was seen to be useful.
Department of Radiation Oncology.
Yasemin Benderli
YB
Cihan
Department of General Surgery, Kayseri Training and Research Hospital, Kayseri, Turkey.
Talha
T
Sarigoz
early stage cancer; locoregional recurrence; modified radical mastectomy; prognostic factors; radiotherapy
Clin Oncol (R Coll Radiol). 2008 Feb;20(1):31-4
18345543
N Engl J Med. 1997 Oct 2;337(14):949-55
9395428
Asian Pac J Cancer Prev. 2014;15(10):4225-31
24935375
Breast Care (Basel). 2011;6(2):136-141
21633630
Breast Cancer Res Treat. 2002 Sep;75(2):167-73
12243509
J Clin Oncol. 2003 Apr 1;21(7):1205-13
12663706
N Engl J Med. 1997 Oct 2;337(14):956-62
9309100
Int J Radiat Oncol Biol Phys. 2014 Jun 1;89(2):392-8
24721590
Int J Radiat Oncol Biol Phys. 2010 Jun 1;77(2):516-22
19577858
Ann Surg Oncol. 2013 Oct;20(10):3169-74
23975289
Ann Surg Oncol. 2014 May;21(5):1569-74
24488216
Cancer. 1989 Jan 1;63(1):181-7
2910416
Jpn J Clin Oncol. 2012 Aug;42(8):711-20
22645150
Int J Radiat Oncol Biol Phys. 2005 Apr 1;61(5):1337-47
15817335
Crit Rev Oncol Hematol. 2011 Aug;79(2):91-102
20615725
J Radiat Res. 2013 Jul 1;54(4):712-8
23392824
Br J Cancer. 1984 Jun;49(6):709-15
6733019
J BUON. 2014 Jul-Sep;19(3):673-80
25261651
Int J Clin Oncol. 2013 Feb;18(1):54-61
22068463
J Clin Oncol. 1999 Jun;17(6):1689-700
10561205
J Clin Oncol. 2011 Jul 20;29(21):2852-8
21670451
J Surg Oncol. 2015 Nov;112(6):569-74
26458282