Local and regional recurrence following mastectomy in breast cancer patients with 1-3 positive nodes: implications for postmastectomy radiotherapy volume

被引:7
作者
Park, Shin-Hyung [1 ]
Lee, Jeeyeon [2 ]
Lee, Jeong Lun [1 ]
Kang, Min Kyu [1 ]
Kim, Mi Young [3 ]
Park, Ho Yong [2 ]
Jung, Jin Hyang [2 ]
Chae, Yee Soo [4 ]
Lee, Soo Jung [4 ]
Kim, Jae-Chul [1 ]
机构
[1] Kyungpook Natl Univ, Sch Med, Dept Radiat Oncol, 130 Dongdeok Ro, Daegu 41944, South Korea
[2] Kyungpook Natl Univ, Sch Med, Dept Surg, Daegu, South Korea
[3] Kyungpook Natl Univ, Dept Radiat Oncol, Chilgok Hosp, Daegu, South Korea
[4] Kyungpook Natl Univ, Sch Med, Dept Hematooncol, Daegu, South Korea
关键词
Breast neoplasms; Recurrence; Mastectomy; Radiotherapy;
D O I
10.3857/roj.2018.00458
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Purpose: To determine the necessity of postmastectomy radiotherapy (PMRT) and which regions would be at risk for recurrence, we evaluated local and regional recurrence in breast cancer patients with 1-3 positive nodes and a tumor size of <5 cm. Materials and Methods: We retrospectively analyzed data of 133 female breast cancer patients with 1-3 positive nodes, and a tumor size of <5 cm who were treated with mastectomy followed by adjuvant systemic therapy between 2007 and 2016. The median follow-up period was 57 months (range, 12 to 115 months). Most patients (82.7%) were treated with axillary lymph node dissection. Adjuvant chemotherapy, endocrine therapy, and trastuzumab therapy were administered to 124 patients (93.2%), 112 (84.2%), and 33 (24.8%), respectively. The most common chemotherapy regimen was anthracycline and cyclophosphamide followed by taxane (71.4%). Results: Three patients (2.3%), 8 6.0%), and 12 (9.0%) experienced local, regional, and distant failures, respectively. The 5-year cumulative risk of local recurrence, regional recurrence, distant metastasis, and disease-free survival was 3.1%, 8.0 0 /0, 11.7%, and 83.4%, respectively. There were no statistically significant clinicopathologic factors associated with local recurrence. Lymphovascular invasion (univariate p = 0.015 and multivariate p = 0.054) was associated with an increased risk of regional recurrence. Conclusion: Our study showed a very low local recurrence in patients with 1-3 positive nodes and tumor size of <5 cm who were treated with mastectomy and modern adjuvant systemic treatment. The PMRT volume need to be tailored for each patient's given risk for local and regional recurrence, and possible radiation-related toxicities.
引用
收藏
页码:285 / 294
页数:10
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