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Improving overall survival with post-mastectomy radiotherapy in a group of early-stage breast cancer: the number of negative lymph nodes sufficient to eliminate post-mastectomy radiotherapy

  • Original Research
  • Published:
Journal of Radiation Oncology

Abstract

Objectives

The role of post-mastectomy radiotherapy (PMRT) in the management of node-negative T1-T2 tumors remains unclear. Clinical decision-making is more complex when suboptimal numbers of nodes are examined. The minimum number of negative nodes required in omitting PMRT in these patients is unknown.

Methods

This is a retrospective study of patients with T1-T2, node-negative tumors who had undergone modified radical mastectomy (MRM). Analyzed were the potential prognostic factors and the variables of taking chemotherapy, hormone therapy, PMRT, as well as the number of examined nodes in different cutoffs, from 0 to 9 nodes.

Results

Five hundred and three eligible patients were studied. The median follow-up was 60 months. The only prognostic factor was the variable of ≤3 vs. >3 nodes (P = 0.01). Other variables did not have a significant effect on the outcome. Analysis showed that without PMRT, the 5 and 10-year overall survival (OS) of 44 patients with ≤3 examined nodes were 76 and 63 %, respectively, and the 5- and 10-year OS rates of 155 patients with >3 examined nodes were 89 and <89 %, respectively (P = 0.02). In the group with PMRT, the 5- and 10-year OS rates of 102 patients with ≤3 examined nodes were 82 and 77 %, respectively, and the 5- and 10-year OS rates of 202 patients with >3 examined nodes were 92 and 88 %, respectively (P = 0.056).

Conclusion

According to the results of the current study on node-negative T1-T2 breast cancer patients, PMRT can overcome the inferior outcome of a suboptimal dissection and improve OS and is therefore recommended as a cutoff point if less than 4 nodes have been examined.

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Acknowledgments

The authors would like to thank all the colleagues at the Omid and Imam Reza oncology centers for their very kindly cooperation.

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Authors and Affiliations

  1. Cancer Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

    Sareh Hosseini & Roham Salek

  2. Cancer Research Center, Omid Hospital, Alandasht Sq., Mashhad, Iran

    Roham Salek

Authors
  1. Sareh Hosseini
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  2. Roham Salek
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Correspondence to Roham Salek.

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Funding

The work was supported by the Cancer Research Center, Faculty of Medicine, Mashhad University of Medical Sciences.

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Author Roham Salek declares that he has no conflict of interest. Author Sareh Hosseini declares that she has no conflict of interest.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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Hosseini, S., Salek, R. Improving overall survival with post-mastectomy radiotherapy in a group of early-stage breast cancer: the number of negative lymph nodes sufficient to eliminate post-mastectomy radiotherapy. J Radiat Oncol 5, 395–399 (2016). https://doi.org/10.1007/s13566-016-0266-3

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  • DOI: https://doi.org/10.1007/s13566-016-0266-3

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