Is there a role for postmastectomy radio therapy in early stage. Node positive breast cancer

ABSTRACT

The aim of this study was to evaluate whether the addition of radiotherapy to mastectomy and adjuvant systemic therapy influenced loco regional control, disease free and overall survival in early stage node positive patients with breast cancer. A total of 263 patients who underwent mastectomy for T1 or T2, node positive breast cancer were retrospectively studied. The systemic therapy consisted of six cycles of combination chemotherapy [FAC or CMF] or hormonal therapy [tamoxifen] for 5 years. One hundred and fifty-two patients received post mastectomy radiotherapy [PMRT], in addition to systemic therapy; while all patients were allocated to systemic therapy alone. Radiotherapy was given to the chest wall, supraclavicular and internal mammary nodes to a total dose of 50 Gy after the second cycle of chemotherapy. The frequency of loco regional recurrence was 5.9% among women who received radiotherapy plus systemic therapy and 41.1% among those who received systemic therapy alone. The 5-year relapse free survival was 85.5% in patients treated with combined modality and 50.5% in those treated with systemic therapy alone. The overall survival at 5 years was 89.5% among those given radiotherapy plus systemic therapy and 63.1% in those who received systemic therapy alone. Radiation toxicity was minimal, mainly skin pigmentation and dry desquamation