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Postmastectomy radiotherapy benefit in Chinese breast cancer patients with T1–T2 tumor and 1–3 positive axillary lymph nodes by molecular subtypes: an analysis of 1369 cases

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Tumor Biology

Abstract

The aim of this study was to examine the association between molecular subtype (MST) and prognosis and research the postmastectomy radiotherapy (PMRT) effect in T1–T2 tumors with 1–3 positive axillary lymph nodes (ALNs). This retrospective study studied breast cancer patients with T1–T2 tumors and 1–3 positive ALNs according to MST: Luminal A, Luminal B, human epidermal growth factor receptor-2 (Her-2) positive, and Triple negative. The impact of adjuvant PMRT in T1–T2 tumors with 1–3 positive ALNs was also assessed. This study included 1369 patients: 33.0 % Luminal A, 42.9 % Luminal B, 11.9 % Her-2 positive, and 12.2 % Triple negative. On univariate and multivariate analyses, MST was associated with locoregional relapse (LRR). Kaplan–Meier analysis showed that PMRT significantly decreased LRR risk (p = 0.017) and distant metastasis (DM) risk (p < 0.0001). In subgroup analysis, PMRT showed significant benefits of improvement in LRR in patients with younger age, positive lymphovascular invasion (LVI), and ratio of positive lymph nodes (LNs) >25 %. Moreover, the nomogram could more accurately predict LRR (c-index 0.75) in T1–2N1 breast cancer patients. MST associated with patient outcomes in breast cancer patients with T1–T2 tumors and 1–3 positive ALN. It makes sense to offer PMRT for patients aged<40 years old, LVI, 2 and 3 positive lymph nodes, and ratio of positive LNs >25 %.

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Acknowledgments

This work was funded by the National Science Foundation of China (81172532, 81470119).

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Authors and Affiliations

  1. Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy of Tianjin, Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Ministry of Education, West Huanhu Road, Ti Yuan Bei, Hexi District, Tianjin, 300060, China

    Honghong Shen, Lin Zhao, Li Wang, Xiaozhen Liu, Junjun Liu, Fengting Niu & Yun Niu

  2. Department of Oncology, General Hospital of Tianjin Medical University, 154 Anshan Road, Heping District, Tianjin, 300052, China

    Xia Liu

  3. Department of Pathology, Nankai University Affiliated Hospital, 190, Jie-Yuan Road, Hong Qiao District, Tianjin, 300121, China

    Shuhua Lv

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  1. Honghong Shen
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  2. Lin Zhao
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  3. Li Wang
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  4. Xiaozhen Liu
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  5. Xia Liu
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  9. Yun Niu
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Correspondence to Yun Niu.

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This study was approved by the Tianjin Medical University Cancer Institute and Hospital, China and has been performed in accordance with the ethical standards laid down in the 1964 Helsinki declaration and its later amendments.

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Synopsis

Our study examined the association between MST and prognosis and researched the PMRT effect in T1–T2 tumors with 1–3 positive ALNs. Data showed MST associated with patient outcomes in breast cancer patients with T1–T2 tumors and 1–3 positive ALNs. PMRT significantly decreased LRR and DM risk. Our results suggest that PMRT should be offered to patients aged <40 years old, LVI, 2 and 3 positive lymph nodes, and ratio of positive LNs >25 %. The nomogram could more accurately predict LRR (c-index 0.75) in T1–2N1 breast cancer patients.

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Shen, H., Zhao, L., Wang, L. et al. Postmastectomy radiotherapy benefit in Chinese breast cancer patients with T1–T2 tumor and 1–3 positive axillary lymph nodes by molecular subtypes: an analysis of 1369 cases. Tumor Biol. 37, 6465–6475 (2016). https://doi.org/10.1007/s13277-015-4546-0

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  • DOI: https://doi.org/10.1007/s13277-015-4546-0

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