Omitting radiation therapy in women with triple-negative breast cancer leads to worse breast cancer-specific survival

Kindts, Isabelle; Buelens, P.; Laenen, Annouschka; Limbergen, Erik; Janssen, Hilde; Wildiers, Hans; Weltens, Caroline

doi:10.1016/j.breast.2016.12.007

Cited by 18 publications

(14 citation statements)

References 37 publications

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“…Other investigators also analyzed the impact of adjuvant RT among TNBC patients with various stages, and the results were inconsistent. Kindts et al [ 19 ] reported that BCS+RT showed a higher breast cancer-specific survival in the whole population compared with mastectomy alone, but not in pT1-2N0 subgroup. Similarly, multi-institutional analysis from five Asian cancer centers demonstrated that BCS+RT was associated with a superior OS compared with mastectomy alone in the whole population, but not in pT1-2N0-1 subgroup [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

Breast Conservation Therapy Versus Mastectomy in Patients with T1-2N1 Triple-Negative Breast Cancer: Pooled Analysis of KROG 14-18 and 14-23

et al. 2018

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PurposeThe aim of this study is to compare the treatment outcomes of breast conserving surgery (BCS) plus radiotherapy (RT) versus mastectomy for patients with pT1-2N1 triple-negative breast cancer (TNBC).Materials and MethodsUsing two multicenter retrospective studies on breast cancer, a pooled analysis was performed among 320 patients with pT1-2N1 TNBC. All patients who underwent BCS (n=212) receivedwhole breast RTwith orwithoutregional nodal RT,while nonewho underwent mastectomy (n=108)received it. All patients received taxane-based adjuvant chemotherapy. The median follow-up periods were 65 months in the BCS+RT group, and 74 months in the mastectomy group.ResultsThe median age of all patients was 48 years (range, 24 to 70 years). Mastectomy group had more patients with multiple tumors (p < 0.001), no lymphovascular invasion (p=0.001), higher number of involved lymph node (p=0.028), and higher nodal ratio ≥ 0.2 (p=0.037). Other characteristics were not significantly different between the two groups. The 5-year locoregionalrecurrence-free, disease-free, and overall survivalrates of BCS+RT group versus mastectomy group were 94.6% versus 87.7%, 89.5% versus 80.4%, and 95.0% versus 87.8%, respectively, and the differences were statistically significant after adjusting for covariates (p=0.010, p=0.006, and p=0.005, respectively).ConclusionIn pT1-2N1 TNBC, breast conservation therapy achieved better locoregional recurrencefree, disease-free, and overall survival rates compared with mastectomy.

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Section: Discussionmentioning

confidence: 99%

Breast Conservation Therapy Versus Mastectomy in Patients with T1-2N1 Triple-Negative Breast Cancer: Pooled Analysis of KROG 14-18 and 14-23

et al. 2018

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“…However, the recommendation of PMRT does not refer to molecular subtypes of breast cancer. A meta-analysis of 22 randomized trials from the Early Breast Cancer Triallists' Collaboration Group (EBCTCG) and other studies showed that radiotherapy could obviously decrease recurrence and mortality risk of TNBC and improve overall survival (OS) of patients with positive lymph nodes [5][6][7]. The value of PMRT for TNBC patients in different pathological nodal stages has not yet been established.…”

Section: Introductionmentioning

confidence: 99%

The effect of postmastectomy radiotherapy in node-positive triple-negative breast cancer

et al. 2020

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Background The value of postmastectomy radiotherapy (PMRT) for pathological node-positive triple-negative breast cancers (TNBC) remains debatable. The aim of this population-based retrospective study was to evaluate the effect of PMRT on survival outcomes in this population. Methods Patients diagnosed with stage T1-4N1-N3M0 TNBC between 2010 and 2014 were identified from the Surveillance, Epidemiology, and End Results (SEER) database. We used univariate and multivariate Cox regression hazards method to determine the independent prognostic factors associated with 3-year breast cancer-specific survival (BCSS). The effect of PMRT on 3-year BCSS was analyzed after stratification by pathological staging of groups. Results Of the 4398 patients included in this study, 2649 (60.2%) received PMRT. Younger age, black ethnicity, and advanced tumor (T) and nodal (N) stage were the independent predictors associated with PMRT receipt (all P < 0.05). Patients who received PMRT showed better 3-year BCSS (OR = 0.720, 95% CI = 0.642–0.808, P < 0.001) than those that did not. The effect of PMRT on 3-year BCSS was analyzed after stratification by pathological staging of groups. The results showed that PMRT was associated with better 3-year BCSS in patients with stage T3–4N1 (P = 0.042), T1-4N2 (P < 0.001), and T1-4N3 (P < 0.001), while comparable 3-year BCSS was found between the PMRT and non-PMRT cohorts with T1–2N1 disease (P = 0.191). Conclusions Radiotherapy achieved better 3-year BCSS in TNBC patients with stage T3–4N1 and T1-4N2–3 disease. However, no survival benefit was found with the addition of PMRT in patients with T1–2N1 TNBC.

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“…Current treatment involves surgery, chemotherapy and radiotherapy. As an integral part of cancer management, radiation therapy is an important locoregional treatment modality, contributing to more than 50% of cancer treatment [6,7]. However, the efficacy of radiotherapy is limited by its own strong side effects that are usually dose dependent [8,9].…”

Section: Introductionmentioning

confidence: 99%

Silencing of XRCC4 increases radiosensitivity of triple-negative breast cancer cells

et al. 2019

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Background: Radiotherapy is an important locoregional treatment, and its effect on triple-negative breast cancer (TNBC) needs to be enhanced. The aim of the present study was to investigate the potential effects of XRCC4 on radiosensitivity of TNBC. Methods: The RNAi technique was implemented to establish the TNBC stable cell line with XRCC4 knockdown. MTT assay was used to detect the effect of XRCC4 knockdown on cell proliferation. Western blot and immunohistochemistry assays were employed to identify protein expression. Colony assay was performed to detect the effect of XRCC4 knockdown on the colony formation ability of TNBC cells with radiation treatment. Comet assay was conducted to evaluate the influence of XRCC4 silencing on DNA repair activity in ionizing radiation. In addition, we performed a survival analysis based on data in TCGA database. Results: XRCC4 knockdown by lentivirus-mediated shRNA had no significant effect on proliferation of TNBC cells. Knockdown of XRCC4 could substantially increase the sensitivity of TNBC cells to ionizing radiation. The DNA damage level was detected to be increased in the XRCC4 knockdown group, indicating there was a significant repair delay in the XRCC4-deleted cells. Clinical sample analysis exhibited that there were various XRCC4 expression in different patients with TNBC. Moreover, survival analysis showed that high expression of XRCC4 was significantly associated with poor progression-free survival after radiotherapy in TNBC patients. Conclusion: Our findings suggest that XRCC4 knockdown sensitizes TNBC cells to ionizing radiation, and could be considered as a novel predictor of radiosensitivity and a promising target for TNBC.

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Omitting radiation therapy in women with triple-negative breast cancer leads to worse breast cancer-specific survival

Cited by 18 publications

References 37 publications

Breast Conservation Therapy Versus Mastectomy in Patients with T1-2N1 Triple-Negative Breast Cancer: Pooled Analysis of KROG 14-18 and 14-23

Breast Conservation Therapy Versus Mastectomy in Patients with T1-2N1 Triple-Negative Breast Cancer: Pooled Analysis of KROG 14-18 and 14-23

The effect of postmastectomy radiotherapy in node-positive triple-negative breast cancer

Silencing of XRCC4 increases radiosensitivity of triple-negative breast cancer cells

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