scholarly journals Impact of postmastectomy radiation therapy in T1-2 breast cancer patients with 1-3 positive axillary lymph nodes

Oncotarget ◽  
2017 ◽  
Vol 8 (30) ◽  
pp. 49564-49573 ◽  
Author(s):  
Hang Yin ◽  
Yuanyuan Qu ◽  
Xiaoyuan Wang ◽  
Tengchuang Ma ◽  
Haiyang Zhang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
Lymph Nodes ◽  
Cancer Patients ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Breast Cancer Patients ◽  
Postmastectomy Radiation ◽  
Postmastectomy Radiation Therapy

scholarly journals Postmastectomy Radiation Therapy can Improve Survival for Breast Cancer Patients with 1-3 Positive Axillary Lymph Nodes: A Retrospective Cohort Study Using SEER Database

2020 ◽  
Author(s):  
Jian Yang ◽  
Xiao Zhang ◽  
Yifeng Ye ◽  
qingmo yang ◽  
Haoyang Cai
Keyword(s):  
Breast Cancer ◽  
Lymph Nodes ◽  
Cancer Patients ◽  
Subgroup Analysis ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Proportional Hazard ◽  
Breast Cancer Patients ◽  
Cox Proportional Hazard ◽  
Postmastectomy Radiation

Abstract Postmastectomy radiation (PMRT) is an important adjuvant treatment for high-risk breast cancer. However, evidence concerning the efficacy of PMRT on survival for breast cancer patients with 1-3 positive axillary lymph nodes remains insufficient. We identified 57,793 patients from the Surveillance, Epidemiology, and End Results database, including 15,126 cases of beam radiation and 42,667 cases of none/unknown radiation. All patients were diagnosed during 2010–2015. Kaplan–Meier curve was utilized to compare the survival of the two groups. We used univariate and multivariate Cox proportional hazard models to identify independent prognostic factors with Hazard Ratio and 95% Confidence Intervals. Patients were stratified according to lymph node status, tumor size and molecular subtypes to perform subgroup analysis. The PMRT group shows more aggressive clinicopathological features, including higher grade (p<0.001), lager tumor size (p<0.001), more lymph nodes (p<0.001), younger age (p<0.001), more ER absence (p<0.001), more PR absence (p<0.001), and more HER2 overexpression (p<0.001). In addition, the PMRT group received more radical surgery (p<0.001) and more chemotherapy (p<0.001). In the multivariable Cox proportional hazard regression analysis, the PMRT group presented improved survival in terms of breast cancer specific survival (BCSS) (HR,0.739; 95% CI, 0.679–0.805; p<0.001) and overall survival (OS) (HR, 0.721; 95% CI, 0.670–0.777; p<0.001). After stratified according to positive axillary lymph nodes, the PMRT group showed improved BCSS and OS in the LN 1 to 3 subgroup (HR, 0.738, 95% CI, 0.639–0.853, p<0.001 and HR, 0.684, 95% CI, 0.604–0.776, p<0.001, respectively). For patients with 1-3 positive axillary lymph nodes and T1-2 tumors, the PMRT group still showed improved survival in terms of BCSS and OS (HR, 0.826, 95% CI, 0.688–0.992, p=0.04 and HR, 0.751, 95% CI, 0.643–0.878, p<0.001, respectively). In the subgroup analysis, PMRT remained a significant favorable prognostic factor in T2 and Her2-/HR+ subtype (p<0.05). This study suggests that even in the era of modern therapy, PMRT can confer a survival benefit to breast cancer patients with 1-3 positive axillary lymph nodes. Furthermore, for patients with 1-3 positive axillary lymph nodes and T1-2 tumors, PMRT can still provide survival benefits.

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