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Therapeutic value of postmastectomy radiation therapy for T1–2 breast cancer with 1–3 positive lymph nodes

  • Original Research
  • Published:
Journal of Radiation Oncology

Abstract

Purpose

Postmastectomy radiation therapy (PMRT) reduces locoregional recurrence (LRR) and breast cancer mortality for node-positive breast cancer, but its indication remains controversial in patients with 1–3 positive lymph nodes.

Methods

We retrospectively analyzed LRR and survival rates in T1–2 breast cancer with 1–3 positive lymph nodes according to PMRT. The prognostic factors and the impact of the current standard systemic therapy (early period: 2000–2007 and late period: 2008–2015) were assessed because adjuvant trastuzumab has only been approved in 2008 in Japan.

Results

Between 2000 and 2015, 162 patients with T1–2N1 breast cancer underwent mastectomy, and 32 (19.8%) underwent PMRT. The 5-year LRR rates were 5.3% in the no PMRT group and 0% in the PMRT group (P = 0.272). Meanwhile, the disease-free survival rates were 80.6% in the no PMRT group and 96.6% in the PMRT group (P = 0.095), and the benefit of PMRT was low in the late period. The significant prognostic factors were larger tumor size (T2) and estrogen receptor negativity.

Conclusions

PMRT tended to improve LRR and disease-free survival. The omission of PMRT is carefully determined.

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Acknowledgments

We thank Ai Shimamoto for data management.

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Authors and Affiliations

  1. Department of Surgical Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima City, Hiroshima, 734-8551, Japan

    Yuri Kimura, Shinsuke Sasada, Noriko Goda, Keiko Kajitani, Akiko Emi, Norio Masumoto, Takayuki Kadoya & Morihito Okada

Authors
  1. Yuri Kimura
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  2. Shinsuke Sasada
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  3. Noriko Goda
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  4. Keiko Kajitani
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  5. Akiko Emi
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  6. Norio Masumoto
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  7. Takayuki Kadoya
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  8. Morihito Okada
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Correspondence to Shinsuke Sasada.

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The authors declare that they have no conflict of interest.

Statement of ethical approval

All human and animal studies have been approved by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. All persons gave their informed consent prior to their inclusion in the study. This article does not contain any studies with animals performed by any of the authors.

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Kimura, Y., Sasada, S., Goda, N. et al. Therapeutic value of postmastectomy radiation therapy for T1–2 breast cancer with 1–3 positive lymph nodes. J Radiat Oncol 8, 323–328 (2019). https://doi.org/10.1007/s13566-019-00402-1

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  • DOI: https://doi.org/10.1007/s13566-019-00402-1

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