Locoregional failure in early-stage breast cancer patients treated with radical mastectomy and adjuvant systemic therapy: Which patients benefit from postmastectomy irradiation?

Marco Trovo, Elena Durofil, Jerry Polesel, Mario Roncadin, Tiziana Perin, Mario Mileto, Erica Piccoli, Daniela Quitadamo, Samuele Massarut, Antonino Carbone, Mauro G. Trovo

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: To assess the locoregional failure in patients with Stage I-II breast cancer treated with radical mastectomy and to evaluate whether a subset of these patients might be at sufficiently high risk of locoregional recurrence (LRR) to benefit from postmastectomy irradiation (PMRT). Methods and Materials: Stage I-II breast cancer patients (n = 150) treated with radical mastectomy without adjuvant irradiation between 1999 and 2005 were analyzed. The pattern of LRR was reported. Kaplan-Meier analysis was used to calculate rates of LRR, and Cox proportional hazards methods were used to evaluate potential risk factors. Results: Median follow-up was 75 months. Mean patient age was 56 years. One-hundred forty-three (95%) patients received adjuvant systemic therapy: 85 (57%) hormonal therapy alone, 14 (9%) chemotherapy alone, and 44 (29%) both chemotherapy and hormonal therapy. Statistically significant factors associated with increased risk of LRR were premenopausal status (p = 0.004), estrogen receptor negative cancer (p = 0.02), pathologic grade 3 (p = 0.02), and lymphovascular invasion (p = 0.001). T and N stage were not associated with increased risk of regional recurrence. The 5-year LRR rate for patients with zero or one, two, three, and four risk factors was 1%, 10.3%, 24.2%, and 75%, respectively. Conclusions: A subset of patients with early-stage breast cancer is at high risk of LRR, and therefore PMRT might be beneficial.

Original languageEnglish
JournalInternational Journal of Radiation Oncology Biology Physics
Volume83
Issue number2
DOIs
Publication statusPublished - Jun 1 2012

Keywords

  • Early breast cancer
  • Local recurrence
  • Pattern of failure
  • Postmastectomy irradiation
  • Risk factors

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Radiation
  • Cancer Research

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