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

Journal Article · Tue Jun 01 00:00:00 EDT 2010 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2009.05.016· OSTI ID:21372302

Chen, C M ^[1]; Liu, M C ^[2]; Jian, J M ^[3]; Horng, C F ^[4]; Liu, M J ^[3]; Yu, B L ^[1]; Lee, M Y ^[5]; Chi, C W ^[6]

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1. Department of Surgery, Sun Yat-Sen Cancer Center, Taipei, Taiwan (China)
2. Department of Medical Oncology, Sun Yat-Sen Cancer Center, Taipei, Taiwan (China)
3. Department of Radiation Oncology, Sun Yat-Sen Cancer Center, Taipei, Taiwan (China)
4. Department of Research, Sun Yat-Sen Cancer Center, Taipei, Taiwan (China)
5. Department of Pathology, Sun Yat-Sen Cancer Center, Taipei, Taiwan (China)
6. Institute of Pharmacology, School of Medicine, National Yang-Ming University, Taipei, Taiwan (China)

Purpose: To define a subgroup of patients at high risk of locoregional recurrence (LRR) who might be benefit from postmastectomy radiotherapy in invasive breast cancer and tumor size <5 cm with one to three involved axillary lymph nodes (T1-2 N1). Methods and Materials: Between April 1991 and December 2005, 544 patients with T1-2 N1 invasive breast cancer were treated with modified radical mastectomy. Of the 544 patients, 383 patients (70.4%) had no radiotherapy, and 161 patients (29.6%) received radiotherapy. We retrospectively compared these two patient groups. Results: With a median follow-up of 40.3 months, LRR occurred in 40 (7.4%) of 544 patients. On univariate analysis, high nuclear grade (p = 0.04), negative estrogen receptor (ER) status (p = 0.001), presence of lymphovascular invasion (LVI) (p = 0.003), and no radiotherapy (p = 0.0015) were associated with a significantly higher rate of LRR. Negative ER status (hazard ratio = 5.1) and presence of LVI (hazard ratio = 2.5) were the risk factors for LRR with statistical significance in the multivariate analysis. Radiotherapy reduced the LRR in patients with the following characteristics: age <40 years, T2 stage, high nuclear grade, negative ER status, and presence of LVI. For 41 patients with negative ER and positive LVI status, radiotherapy can reduce LRR from 10 of 25 (40%) to 2 of 16 (12.5%) and increase the 5-year overall survival from 43.7% to 87.1%. Conclusion: Radiotherapy can reduce LRR and increase survival in T1-2 N1 breast cancer patients with negative ER status and presence of LVI.

• OSTI ID: 21372302
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Vol. 77, Issue 2; Other Information: DOI: 10.1016/j.ijrobp.2009.05.016; PII: S0360-3016(09)00766-4; Copyright (c) 2010 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; ISSN 0360-3016
• Country of Publication: United States
• Language: English

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