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Comparison of Breast Conserving Surgery Followed by Radiation Therapy with Mastectomy Alone for Pathologic N1 Breast Cancer Patients in the Era of Anthracycline Plus Taxane-Based Chemotherapy: A Multicenter Retrospective Study (KROG 1418) / Journal of the Korean Cancer Association, 대한암학회지
Cancer Research and Treatment ; : 1041-1051, 2019.
Article in English | WPRIM | ID: wpr-763175
ABSTRACT

PURPOSE:

We compared the oncologic outcomes of breast-conserving surgery plus radiation therapy (BCS+RT) and modified radical mastectomy (MRM) under anthracycline plus taxane-based (AT) regimens and investigated the role of adjuvant radiation therapy (RT) in patients with pathologic N1 (pN1) breast cancer treated by mastectomy. MATERIALS AND

METHODS:

We retrospectively reviewed the medical records of 2,011 patients with pN1 breast cancer who underwent BCS+RT or MRM alone at 12 institutions between January 2006 and December 2010. Two-to-one propensity score matching was performed for balances in variables between the groups.

RESULTS:

The median follow-up duration for the total cohort was 69 months (range, 1 to 114 months). After propensity score matching, 1,074 patients (676 in the BCS+RT group and 398 in the MRM-alone group) were analyzed finally. The overall survival, disease-free survival, locoregional failure-free survival, and regional failure-free survival (RFFS) curves of the BCS+RT group vs. MRM-alone group were not significantly different. The subgroup analysis revealed that in the group with both lymphovascular invasion (LVI) and histologic grade (HG) III, the BCS+RT showed significantly superior RFFS (p=0.008). Lymphedema (p=0.007) and radiation pneumonitis (p=0.031) occurred more frequently in the BCS+RT group than in the MRM-alone group, significantly.

CONCLUSION:

There are no differences in oncologic outcomes between BCS+RT and MRM-alone groups under the AT chemotherapy regimens for pN1 breast cancer. However, BCS+RT group showed superior RFFS to MRM-alone group in the patients with LVI and HG III. Adjuvant RT might be considerable for pN1 breast cancer patients with LVI and HG III.
Subject(s)

Full text: Available Index: WPRIM (Western Pacific) Main subject: Breast / Breast Neoplasms / Mastectomy, Modified Radical / Mastectomy, Segmental / Medical Records / Retrospective Studies / Cohort Studies / Follow-Up Studies / Radiation Pneumonitis / Disease-Free Survival Type of study: Etiology study / Incidence study / Observational study / Prognostic study / Risk factors Limits: Humans Language: English Journal: Cancer Research and Treatment Year: 2019 Type: Article

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Full text: Available Index: WPRIM (Western Pacific) Main subject: Breast / Breast Neoplasms / Mastectomy, Modified Radical / Mastectomy, Segmental / Medical Records / Retrospective Studies / Cohort Studies / Follow-Up Studies / Radiation Pneumonitis / Disease-Free Survival Type of study: Etiology study / Incidence study / Observational study / Prognostic study / Risk factors Limits: Humans Language: English Journal: Cancer Research and Treatment Year: 2019 Type: Article