Influence of Lymphatic Invasion on Locoregional Recurrence Following Mastectomy: Indication for Postmastectomy Radiotherapy for Breast Cancer Patients With One to Three Positive Nodes

Journal Article · Sun Jul 01 04:00:00 EDT 2012 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/J.IJROBP.2011.08.029· OSTI ID:22058883

Matsunuma, Ryoichi ^[1]; Oguchi, Masahiko ^[2]; Fujikane, Tomoko ^[1]; Matsuura, Masaaki ^[3]; Sakai, Takehiko; Kimura, Kiyomi; Morizono, Hidetomo; Iijima, Kotaro; Izumori, Ayumi; Miyagi, Yumi; Nishimura, Seiichiro; Makita, Masujiro ^[1]; Gomi, Naoya ^[4]; Horii, Rie ^[5]; Akiyama, Futoshi ^[6]; Iwase, Takuji ^[1]

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1. Department of Surgery, Breast Oncology Center, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo (Japan)
2. Radiation Oncology Department, Breast Oncology Center, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo (Japan)
3. Bioinformatics Group, Genome Center of the Japanese Foundation for Cancer Research and Division of Cancer Genomics, Cancer Institute of the Japanese Foundation for Cancer Research, Tokyo (Japan)
4. Department of Diagnostic Imaging, Breast Oncology Center, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo (Japan)
5. Division of Pathology, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo (Japan)
6. Division of Pathology, Cancer Institute of the Japanese Foundation for Cancer Research, Tokyo (Japan)

Purpose: The indication for postmastectomy radiotherapy (PMRT) in breast cancer patients with one to three positive lymph nodes has been in discussion. The purpose of this study was to identify patient groups for whom PMRT may be indicated, focusing on varied locoregional recurrence rates depending on lymphatic invasion (ly) status. Methods and Materials: Retrospective analysis of 1,994 node-positive patients who had undergone mastectomy without postoperative radiotherapy between January 1990 and December 2000 at our hospital was performed. Patient groups for whom PMRT should be indicated were assessed using statistical tests based on the relationship between locoregional recurrence rate and ly status. Results: Multivariate analysis showed that the ly status affected the locoregional recurrence rate to as great a degree as the number of positive lymph nodes (p < 0.001). Especially for patients with one to three positive nodes, extensive ly was a more significant factor than stage T3 in the TNM staging system for locoregional recurrence (p < 0.001 vs. p = 0.295). Conclusion: Among postmastectomy patients with one to three positive lymph nodes, patients with extensive ly seem to require local therapy regimens similar to those used for patients with four or more positive nodes and also seem to require consideration of the use of PMRT.

• OSTI ID: 22058883
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 3 Vol. 83; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
LYMPH NODES
MAMMARY GLANDS
MULTIVARIATE ANALYSIS
NEOPLASMS
PATIENTS
RADIOTHERAPY