Locoregional Failure 15 Years after Mastectomy in Women with One to Three Positive Axillary Nodes with or without Irradiation

Abstract

Patients with T1 tumor and one to three positive nodes are at low risk of isolated LRR either with or without RT. Patients with T2 tumor and one to three positive nodes are at high risk of isolated LRR without RT. Our findings support the routine use of PMRT in patients with T2 tumor, especially those aged < or = 45 years.

Effect of Postmastectomy Radiotherapy in Patients <35 Years Old With Stage II-III Breast Cancer Treated With Doxorubicin-Based Neoadjuvant Chemotherapy and Mastectomy

“…Furthermore, a large meta-analysis of five National Surgical Adjuvant Breast Project trials with >5,700 patients with all disease stages treated with mastectomy and adjuvant chemotherapy found that younger patients had greater rates of LRR with or without distant failure (26.1% among the 20-39-year-old patients) (14). Finally, retrospective reports, including one from our institution that included patients with Stage II-III disease treated with neoadjuvant chemotherapy and mastectomy, have suggested that young age is a risk factor for LRR (15,16). Although these studies suggest that young age might be an adverse prognostic factor for outcome, it is important to note that not all reports have shown similar results (17)(18)(19).…”

Quality Assurance in the EORTC Randomized Trial 22922/10925 Investigating the Role of Irradiation of the Internal Mammary and Medial Supraclavicular Lymph Node Chain Works

“…The doses at the points P(IM) and P (3,3) are displayed in Tables 3a and 3b for the treatment plans "without IM-MS irradiation" and in Tables 4a and 4b for the treatment plans "with IM-MS irradiation". In general, thoracic wall irradiation with an electron field technique more often resulted in an unintended high dose to the IM nodes in arm 1 and the customized techniques more often led to a good coverage of the IM lymph node region in arm 2 (data not shown).…”

Austrian Breast Cancer Patterns-of-Care Studies PCS93 and PCS01 versus PCS85 to Identify Changes in National Practice

“…In patients surveyed by the Austrian Breast Cancer Patterns-of-Care Studies, the percentage of patients treated with supraclavicular node irradiation diminished clearly from 77% (PCS85) to 35% (PCS93) and 28% (PCS01). At present, several indications for supraclavicular node radiotherapy are under discussion such as patients with ≥ 4 positive axillary nodes irrespective of T-category or patients with ≥ pT2 tumors and 1-3 positive axillary nodes or extracapsular tumor extension [4,8,9,33,34]. In PCS01, 34 of 120 patients received supraclavicular radiotherapy and 85% of them fulfilled these criteria.…”