Postmastectomy radiation therapy in T3 node-negative breast cancer

Elmore, Leisha C.; Deshpande, Ashwini; Daly, Mackenzie; Margenthaler, Julie A.

doi:10.1016/j.jss.2015.04.012

Cited by 10 publications

(8 citation statements)

References 17 publications

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“…Published data on the positive associations between being married and undergoing mammography screening [30] and with breast cancer treatment uptake [31, 32] may explain some of the associations between marital status and mortality following breast cancer diagnosis, although the beneficial effect of marriage on breast cancer survival persists after accounting for treatment [6]. Two main pathways have been proposed to explain the benefits of marital status on cancer and overall longevity [33]: better economic resources and greater social support.…”

Section: Discussionmentioning

confidence: 99%

Prognostic significance of marital status in breast cancer survival: A population-based study

Martı́nez

Unkart

et al. 2017

PLoS ONE

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Research shows that married cancer patients have lower mortality than unmarried patients but few data exist for breast cancer. We assessed total mortality associated with marital status, with attention to differences by race/ethnicity, tumor subtype, and neighborhood socioeconomic status (nSES). We included, from the population-based California Cancer Registry, women ages 18 and older with invasive breast cancer diagnosed between 2005 and 2012 with follow-up through December 2013. We estimated mortality rate ratios (MRR) and 95% confidence intervals (CI) for total mortality by nSES, race/ethnicity, and tumor subtype. Among 145,564 breast cancer cases, 42.7% were unmarried at the time of diagnosis. In multivariable-adjusted models, the MRR (95% CI) for unmarried compared to married women was 1.28 (1.24–1.32) for total mortality. Significant interactions were observed by race/ethnicity (P<0.001), tumor subtype (P<0.001), and nSES (P = 0.009). Higher MRRs were observed for non-Hispanic whites and Asians/Pacific Islanders than for blacks or Hispanics, and for HR+/HER2+ tumors than other subtypes. Assessment of interactive effect between marital status and nSES showed that unmarried women living in low SES neighborhoods had a higher risk of dying compared with married women in high SES neighborhoods (MRR = 1.60; 95% CI: 1.53–1.67). Unmarried breast cancer patients have higher total mortality than married patients; the association varies by race/ethnicity, tumor subtype, and nSES. Unmarried status should be further evaluated as a breast cancer prognostic factor. Identification of underlying causes of the marital status associations is needed to design interventions that could improve survival for unmarried breast cancer patients.

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Section: Discussionmentioning

confidence: 99%

Prognostic significance of marital status in breast cancer survival: A population-based study

Martı́nez

Unkart

et al. 2017

PLoS ONE

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“…There have been no prospective studies to address the administration of PMRT in T3N0 breast cancer, and to date, most retrospective studies show a questionable benefit of PMRT 10,18,20 . Two previous study published 20 years ago (DBCG 82b and 82c trials) included T3N0 breast cancers; however, the limited number of enrolled patients make it difficult to draw definitive conclusions regarding the survival benefit of PMRT in this setting 24,25 .…”

Section: Discussionmentioning

confidence: 99%

“…A study from the NCDB included patients diagnosed between 2004 and 2012, among whom PMRT was administered in 45‐50% of patients, and PMRT was related to better OS for this population 16 . However, several recent retrospective and population‐based studies showed conflicting results 10,11,18–25 . The study population, clinical pathological features, and differences in treatment patterns might contribute to the significant differences in the above results.…”

Section: Discussionmentioning

confidence: 99%

“…However, two studies from the National Cancer Database (NCDB) showed better overall survival (OS) with the administration of chemotherapy 16,17 . There were also conflicting results regarding the role of PMRT in this patient subset 10,11,18–25 . Therefore, T3N0 breast cancer might be a distinct clinical and biological entity, with higher heterogeneity and presenting diverse responses to locoregional and systemic therapy.…”

Section: Introductionmentioning

confidence: 99%

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Prognostic validation and therapeutic decision‐making of the AJCC eighth pathological prognostic staging for T3N0 breast cancer after mastectomy

Wang

Lei

et al. 2020

Clinical & Translational Med

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Background T3N0 breast cancer might be a distinct clinical and biological entity, with higher heterogeneity and presenting diverse responses to locoregional and systemic therapy. The aim of the current study was to validate the prognostic effect and assess the treatment decision‐making of the American Joint Committee on Cancer (AJCC) eighth pathological prognostic staging in T3N0 breast cancer after mastectomy. Methods We retrospectively included 2465 patients with stage T3N0 breast cancer who had undergone mastectomy between 2010 and 2014 using the data from Surveillance, Epidemiology, and End Results program. The primary endpoint of this study was breast cancer–specific survival (BCSS). Results Of the entire cohort, 76.0% of patients in the seventh AJCC staging system were restaged to the eighth AJCC pathological prognostic staging system. A total of 1431 (58.1%) and 1175 (47.7%) of them received chemotherapy and postmastectomy radiotherapy (PMRT), respectively. Pathological staging was an independent prognostic factor for BCSS. Using pathological prognostic stage IA as the reference, BCSS gradually became worse with increased hazard ratios. The 5‐years BCSS was 96.9%, 95.5%, 91.1%, 85.6%, and 75.5% in pathological prognostic stage IA, IB, IIA, IIB, and IIIA breast cancers, respectively (P < .001). In pathological prognostic stage IA, IB, and IIA breast cancers, the receipt of PMRT or chemotherapy was not correlated with better BCSS. However, PMRT was correlated with better BCSS in pathological prognostic stage IIB disease (P = .006), but not in pathological prognostic IIIA disease. Moreover, chemotherapy was correlated with better BCSS in pathological prognostic stage IIIA disease (P = .006), but not in pathological prognostic stage IIB disease. Conclusions The eighth AJCC pathological prognostic staging system provides more risk stratification of T3N0 breast cancers after mastectomy and might affect individualized decision‐making for chemotherapy and PMRT in this patient subset.

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“…В нашей стране рак молочной железы (РМЖ) занимает лидирующие позиции по заболеваемости и смертности среди женского населения [1]. По данным литературы, доля женщин с T3-4N0M0 стадией РМЖ в общей массе пациенток с этим диагнозом находится на уровне 2-7 % [2][3][4][5][6][7]. При T3N0M0 (IIb) стадии заболевания опухоль достигает размера более 5 см, а при T4N0M0 (IIIb) стадии РМЖ в злокачественный процесс вовлечена кожа и/или грудная стенка.…”

Section: Introductionunclassified

Clinical and Biological Characteristics of T3n0m0 and T4n0m0 Breast Cancer

et al. 2022

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Аннотация: Рак молочной железы (РМЖ) T3-4N0M0 стадий среди всех опухолей данной локализации встречается нечасто. Клинические особенности подобных опухолей и их биологическая природа освещены в научной литературе довольно скудно. В нашей работе мы показали, что женщины с T3N0M0 и T4N0M0 стадиями РМЖ имели ряд общих клинических признаков, сопутствующих заболеваний и биологических характеристик опухоли. При этом карциномы отличались по агрессивности и характеру течения опухолевого процесса. В группе T3N0M0 длительность анамнеза оказалась меньше, а средний размер опухоли больше, чем в группе T4N0M0, что говорит о более высокой скорости роста опухолей в первой группе. Также в группе T3N0M0 среднее значение индекса пролиферации ki-67 было выше по сравнению с группой T4N0M0. Удельный вес тройного-негативного и люминального В Her2-отрицательного биологических подтипов преобладали как в группе T3N0M0, так и в группе T4N0M0. При РМЖ T3-4N0M0 стадий доля карцином с нулевой и слабой экспрессией гормональных рецепторов составляла более 50 %. Таким образом, в нашем исследовании у значительной части больных с T3-4N0M0 стадией заболевания опухоль была агрессивной и потенциально высокочувствительной к системной химиотерапии.Ключевые слова: рак молочной железы, клинические особенности, патоморфологические особенности, размер опухоли, форма роста, гистологические типы, биологические подтипы, экспрессия гормональных рецепторов.

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Postmastectomy radiation therapy in T3 node-negative breast cancer

Cited by 10 publications

References 17 publications

Prognostic significance of marital status in breast cancer survival: A population-based study

Prognostic significance of marital status in breast cancer survival: A population-based study

Prognostic validation and therapeutic decision‐making of the AJCC eighth pathological prognostic staging for T3N0 breast cancer after mastectomy

Clinical and Biological Characteristics of T3n0m0 and T4n0m0 Breast Cancer

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