Postoperative periclavicular radiotherapy in breast cancer patients with 1–3 positive axillary lymph nodes

Biancosino, A.; Bremer, Michael; Karstens, Johann H.; Biancosino, Christian; Meyer, Andreas

doi:10.1007/s00066-012-0083-6

Cited by 9 publications

(4 citation statements)

References 50 publications

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“…Yu et al (2013) reported supraclavicular radiation therapy (SCRT) was a significant predictor of locoregional recurrence-free survival (but not DMFS or OS) in patients with ≥2 risk factors. Biancosino et al (2012) reported RT to the supraclavicular and infraclavicular lymphatic drainage area in patients with positive ALN who underwent breastpreserving surgery failed to improve the focal control, disease-free survival, and OS. Macdonald et al (2009) compared RT at chest wall alone with RT at the chest wall and supra-and infraclavicular lymphatic drainage area in patients who underwent complete mastectomy due to T1-2N1 breast cancer.…”

Section: Discussionmentioning

confidence: 98%

Benefit of Post-mastectomy Radiotherapy of the Supra-/infraclavicular Lymphatic Drainage Area in Breast Cancer Patients

Wu²,

Zhou³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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Section: Discussionmentioning

confidence: 98%

Benefit of Post-mastectomy Radiotherapy of the Supra-/infraclavicular Lymphatic Drainage Area in Breast Cancer Patients

Wu²,

Zhou³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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“…The authors concluded that there was no benefit associated with the addition of supraclavicular irradiation for patients treated with a modern systemic therapy regimen. Similarly, Biancosino et al [25] compared clinical outcomes among pN1 breast cancer patients who underwent breast-conserving surgery and breast irradiation with or without periclavicular irradiation. The authors reported no statistical differences in terms of LRR-free survival, DFS, or OS.…”

Section: Discussionmentioning

confidence: 99%

Regional nodal irradiation in pT1-2N1 breast cancer patients treated with breast-conserving surgery and whole breast irradiation

Park

Kim

2020

Radiat Oncol J

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To evaluate the necessity of regional nodal irradiation (RNI) for pT1-2N1 breast cancer patients treated with breast-conserving surgery and radiotherapy, we compared clinical outcomes of patients treated with and without RNI. Materials and Methods: We retrospectively analyzed the data of 214 pT1-2N1 breast cancer patients treated with breast-conserving surgery and whole breast irradiation from 2007-2016. There were 142 (66.4%), 51 (23.85%), and 21 (9.8%) patients with one, two, and three positive lymph nodes, respectively. Thirty-six patients (16.8%) underwent RNI. Adjuvant chemotherapy, endocrine therapy, and anti-HER2 therapy were given to 91.6%, 79.0%, and 15.0% patients, respectively. The most common chemotherapy regimen was anthracycline + cyclophosphamide, followed by taxane (76.5%). The median follow-up was 64 months (range, 6 to 147 months). Patients were propensity matched 1:2 into RNI and no-RNI groups. Results: Two patients experienced locoregional recurrences simultaneously with distant metastases, ten patients developed distant metastases, and one patient died. Before matching, the 5-year actuarial locoregional control (LRC), distant metastasis-free survival (DMFS), and overall survival (OS) rates in the RNI and no-RNI groups were 100.0% and 99.4% (p = 0.629), 94.1% and 96.0% (p = 0.676), and 100.0% and 99.4% (p = 0.658), respectively. After matching, the 5-year LRC, DMFS, and OS were 98.3% and 100.0% (p = 0.455), 96.6% and 93.9% (p = 0.557), and 100.0% and 100.0% (p > 0.999) in the RNI and no-RNI groups, respectively. No clinicopathologic or treatment-related factors were significantly associated with LRC, DMFS, or OS. Conclusion: Adding RNI did not show superior LRC, DMFS, or OS in pT1-2N1 breast cancer patients.

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“…Sharma et al [ 6 ] also found that the 10-year LRR of patients with stage T2 breast cancer was higher than that of patients with stage T1 cancer ( p =0.020). In addition, several reports demonstrated that patients with 2–3 positive nodes had a higher risk of supraclavicular fossa recurrence than those with 1 positive node, suggesting that supraclavicular fossa radiotherapy should be considered in the subset of patients with 2–3 positive nodes [ 28 29 ].…”

Section: Discussionmentioning

confidence: 99%

Predictive Value of Molecular Subtyping for Locoregional Recurrence in Early-Stage Breast Cancer with N1 without Postmastectomy Radiotherapy

Wen

Zhang

et al. 2016

J Breast Cancer

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PurposeThis study was designed to investigate the relationship between molecular subtype and locoregional recurrence (LRR) in patients with early-stage breast cancer with 1–3 positive axillary lymph nodes (ALNs) and improve the individualized indications for postmastectomy radiotherapy (PMRT).MethodsThe records of 701 patients with pT1-2N1M0 breast cancer who did not undergo PMRT were retrospectively analyzed. Tumors were subclassified as follows: luminal A, luminal B, human epidermal growth factor receptor 2 (HER2)-enriched, and basal-like subtypes. Multivariate Cox analysis was used to determine the risk of LRR associated with the different subtypes and to adjust for clinicopathologic factors.ResultsLuminal A, luminal B, HER2-enriched, and basal-like subtypes accounted for 51.2%, 28.0%, 8.1%, and 12.7% of cases, respectively. The median follow-up duration was 67 months (range, 9–156 months). Univariate analysis revealed that, compared with the luminal A subtype, the HER2-enriched and basal-like subtypes were associated with significantly higher 5-year LRR rates (5.6% vs. 21.6% and vs.15.7% respectively; p=0.002 each), lower 5-year LRR-free survival (LRFS) rates (90.6% vs. 73.8% and 78.5%, respectively; p=0.001 each), and poorer 5-year breast cancer-specific survival (BCSS) rates (93.7% vs. 82.2% [p=0.002] and 84.9% [p=0.001], respectively). Multivariate analysis revealed that the HER2-enriched and basal-like subtypes, age ≤35 years, a medial tumor, and pT2 stage were poor prognostic factors for LRR and LRFS; furthermore, 2 to 3 positive ALNs represented an independent prognostic factor affecting LRR. The 10-year LRR rates of patients with 0, 1, 2, 3, and 4 risk factors were 1.0%, 6.9%, 14.3%, 30.4%, and 54.3%, respectively (p<0.001); the 10-year BCSS rates were 86.6%, 88.5%, 84.4%, 79.7%, and 38.8%, respectively (p<0.001).ConclusionMolecular subtyping allows for individualized evaluation of LRR risk in patients with pT1-2N1M0 breast cancer. PMRT should be recommended for patients with ≥3 LRR risk factors.

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Postoperative periclavicular radiotherapy in breast cancer patients with 1–3 positive axillary lymph nodes

Cited by 9 publications

References 50 publications

Benefit of Post-mastectomy Radiotherapy of the Supra-/infraclavicular Lymphatic Drainage Area in Breast Cancer Patients

Benefit of Post-mastectomy Radiotherapy of the Supra-/infraclavicular Lymphatic Drainage Area in Breast Cancer Patients

Regional nodal irradiation in pT1-2N1 breast cancer patients treated with breast-conserving surgery and whole breast irradiation

Predictive Value of Molecular Subtyping for Locoregional Recurrence in Early-Stage Breast Cancer with N1 without Postmastectomy Radiotherapy

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