Clinical value of radiotherapy in 78 patients with pT3 N0 M0 breast cancer after modified radical mastectomy / 中华放射肿瘤学杂志

ABSTRACT

Objective To investigate the value of post-mastectomy radiotherapy ( PMRT ) in patients with T3 N0 breast cancer ( BC ) who were treated with modified radical mastectomy ( MRM ) . Methods A retrospective analysis was performed on the clinical data of BC patients treated with MRM from 1997 to 2014. The inclusion criteria were as follows( 1 ) female patients;( 2 ) pathological diagnosis of invasive BC;(3) tumor volume greater than 5 cm without axillary lymph node metastasis;(4) the patients who received no neoadjuvant chemotherapy or endocrine therapy and had no distant metastasis or other second primary cancers. A total of 78 patients met the inclusion criteria. Forty patients ( 51%) received PMRT and sixty-seven patients (86%) received adjuvant chemotherapy. The Kaplan-Meier method was used to calculate overall survival ( OS ) , disease-free survival ( DFS ) ( DFS ) , and local-regional recurrence ( LRR) rates, and survival differences between groups were analyzed by the log-rank test. Results The median follow-up time was 79 months ( 6-232 months) . For all patients, the 5-year OS, DFS, and LRR rates were 89%, 87%, and 2%, respectively. The 5-year DFS, OS and LRR rates for radiotherapy group were 84%, 84% and 0%, respectively, versus 91%( P= 0641 ) , 96%( P= 0126 ) , and 5% for non-radiotherapy group. Only estrogen receptor/progesterone receptor ( ER/PR) status and molecular type had significant impacts on DFS ( P=0002 and 0031, respectively) . One patient in non-radiotherapy group had chest wall recurrence. Conclusions MRM is effective in reducing LRR in T3 N0 M0 BC patients. Only ER/PR status and molecular type significantly influence DFS. Effective systemic therapy may be helpful for some T3 N0 patients to avoid chest wall and supraclavicular radiotherapy after MRM, but large-sample studies are needed to further confirm this conclusion.