Radiotherapy Can Decrease Locoregional Recurrence and Increase Survival in Mastectomy Patients With T1 to T2 Breast Cancer and One to Three Positive Nodes With Negative Estrogen Receptor and Positive Lymphovascular Invasion Status

Yang, Po Sheng; Chen, Chi Ming; Liu, Mei Ching; Jian, Jer Min; Horng, Cheng-Fang; Liu, Ming Jiung; Yu, Ben-Long; Lee, Ming Yuan; Wen, Chin

doi:10.1016/j.ijrobp.2009.05.016

Cited by 58 publications

(46 citation statements)

References 35 publications

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“…While they determined no significant difference in locoregional recurrence rates between the patients receiving and not receiving PMRT in the T1 tumor patient subgroup, the locoregional recurrence rate was significantly lower in T2 tumor patients who received PMRT. In a series of 544 T1-2N1 disease patients, mostly receiving adjuvant systemic therapy (including a small number of patients with ,10 lymph nodes removed), Yang et al (33) found the locoregional recurrence rate to be lower in patients who received PMRT compared with those who did not. In the T1 tumor patient subgroup, there was no significant difference between the patients receiving and not receiving PMRT in terms of the locoregional recurrence rate, whereas in the T2 tumor patient subgroup, this rate was significantly lower in patients who received PMRT compared with those who did not.…”

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confidence: 99%

Survival Benefit of Post-mastectomy Radiotherapy in Breast Carcinoma Patients with T1-2 Tumor and 1-3 Axillary Lymph Node(s) Metastasis

Duraker

Demir

Batı

et al. 2012

Japanese Journal of Clinical Oncology

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Objective: To investigate the role of post-mastectomy radiotherapy in breast carcinoma patients with a tumor size of 5 cm or smaller (T1-2) and 1 -3 axillary lymph node(s) metastasis (N1). Methods: We retrospectively reviewed the file records of 575 patients receiving radiotherapy (452 patients) and not receiving radiotherapy (123 patients). Results: In the whole series, locoregional recurrence-free survival was significantly better in patients receiving radiotherapy compared with patients not receiving radiotherapy (P , 0.001); in the multivariate Cox analysis, radiotherapy had an independent prognostic value (P , 0.001). In patients with a tumor size of 2 cm or less (T1), locoregional recurrence-free survival was significantly better in patients receiving radiotherapy compared with those not receiving radiotherapy (P ¼ 0.016). In the patient subgroup with a T1 tumor and a lymph node ratio (the ratio of the number of metastatic lymph nodes to the number of removed lymph nodes) of 0.25 or less, there was no significant difference between the patients receiving and not receiving radiotherapy in terms of locoregional recurrence-free survival (P ¼ 0.071). In patients with a tumor size of 2.1 -5 cm (T2), locoregional recurrence-free survival was significantly better for patients who received radiotherapy compared with those who did not (P ¼ 0.001). In patients with a T2 tumor and a lymph node ratio of 0.08, there was no significant difference in locoregional recurrence-free survival between the patients receiving and not receiving radiotherapy (P ¼ 0.645). Conclusions: Post-mastectomy radiotherapy is beneficial in reducing the locoregional recurrence risk in T1N1 breast carcinoma patients with a lymph node ratio of .0.25 and in T2N1 breast carcinoma patients with a lymph node ratio of .0.08. In patients with a lymph node ratio equal to or less than these ratios, post-mastectomy radiotherapy could be omitted to avoid radiotherapy-related risks.

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confidence: 99%

Survival Benefit of Post-mastectomy Radiotherapy in Breast Carcinoma Patients with T1-2 Tumor and 1-3 Axillary Lymph Node(s) Metastasis

Duraker

Demir

Batı

et al. 2012

Japanese Journal of Clinical Oncology

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“…Lacking randomized trials, the role of clavicular node irradiation is still debated in patients with early disease (pT1-T2) and few (≤3) metastatic axillary lymph nodes, although certain studies suggest that in this group there are classes of high-risk patients who can benefit from radiotherapy to nodal stations in view of clinical and pathological risk factors: those with triple-negative disease, young age, nodal ratio >25%, with vascular invasion, extra-capsular extension, tumor size >3 cm (15)(16)(17).…”

Section: Discussionmentioning

confidence: 99%

Outcomes in Patients with pT1-T2, pN0-N1 Breast Cancer After Conservative Surgery and Whole-breast Radiotherapy

Trignani¹,

Carlo²,

Cefalogli³

et al. 2017

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“…Various clinical and pathologic risk factors for such locoregional failure have been reported [8][9][10][11][12] : hormone receptor negativity 8,10,11 , younger age (<40 or <45 years of age) 8,9 , ratio of positive lymph nodes to dissected lymph nodes (25%) 8,12 , presence of lvi 11 , pT2 10 , 2 or 3 positive lymph nodes (compared with 1 positive node) 10 , and a medial tumour location 8 .…”

Section: Discussionmentioning

confidence: 99%

Irradiation after Surgery for Breast Cancer Patients with Primary Tumours and One to Three Positive Axillary Lymph Nodes: Yes or No?

Chen

et al. 2013

Current Oncology

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Objective and Methods: We retrospectively analyzed clinicopathologic features and survival in breast cancer patients who had T1 or T2 primary tumours and 1–3 histologically involved axillary lymph nodes and who were treated with modified radical mastectomy without adjuvant radiotherapy (RT). We also explored prognosis to find the high- and low-risk groups. Results: From May 2001 to April 2005, 368 patients treated at Tianjin Tumor Hospital met the study criteria. The 5- and 8-year rates were 7.2% and 10.7% for locoregional recurrence (LRR), 85.1% and 77.7% for disease-free survival (DFS), and 92.8% and 89.3% for overall survival (OS). Multivariate Cox regression analysis showed that age, tumour size, estrogen receptor (ER) status, and lymphovascular invasion (LVI) were independent prognostic factors for LRR and DFS. Based on 4 patient-related factors that indicate poor prognosis (age < 40 years, tumour > 3 cm, ER negativity, and LVI), the high-risk group (patients with 3 or 4 factors, accounting for 12.5% of the cohort) had 5- and 8-year rates of 24.3% and 36.9% for LRR, 57.2% and 39.2% for DFS, and 74.8% and 43.8% for OS compared with 5.0% and 7.1% for LRR, 88.9% and 83.1% for DFS, 91.6% and 83.4% for OS in the low-risk group (patients with 0–2 factors, accounting for 87.5% of the cohort; p < 0.001). Conclusions: Our study identified several risk factors that correlated independently with a greater incidence of LRR and distant metastasis in patients with T1 and T2 breast cancer and 1–3 positive nodes. Patients with 0–2 risk factors may not be likely to benefit from post-mastectomy RT, but patients with 3–4 risk factors may need RT to optimize locoregional control and improve survival.

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Radiotherapy Can Decrease Locoregional Recurrence and Increase Survival in Mastectomy Patients With T1 to T2 Breast Cancer and One to Three Positive Nodes With Negative Estrogen Receptor and Positive Lymphovascular Invasion Status

Cited by 58 publications

References 35 publications

Survival Benefit of Post-mastectomy Radiotherapy in Breast Carcinoma Patients with T1-2 Tumor and 1-3 Axillary Lymph Node(s) Metastasis

Survival Benefit of Post-mastectomy Radiotherapy in Breast Carcinoma Patients with T1-2 Tumor and 1-3 Axillary Lymph Node(s) Metastasis

Outcomes in Patients with pT1-T2, pN0-N1 Breast Cancer After Conservative Surgery and Whole-breast Radiotherapy

Irradiation after Surgery for Breast Cancer Patients with Primary Tumours and One to Three Positive Axillary Lymph Nodes: Yes or No?

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