Post Mastectomy Radiotherapy for High Risk T1-T2N0 Breast Cancer …. Does it Make Difference? | ||
| SECI Oncology Journal | ||
| Volume 12, Issue 1, January 2024, Pages 88-96 | ||
| Abstract | ||
| Background: Early breast cancer cases usually have good prognosis and long- term survival. but a subgroup of them develop locoregional failure. Studying those cases have shown that they have multiple risk factors such as tumor site and size, menopausal and hormonal status, also presence or absence of lymphovascular invasion (LVI). Many radiotherapists still confused about giving adjuvant radiotherapy to that group of patients. This study seeks to document our experience about detecting the high-risk factors for local failure in T1-T2 N0 breast cancer cases after mastectomy. Also, to identify if this subgroup could have a benefit from post mastectomy radiation therapy. Methods: This is a retrospective study of 588 cases of node-negative early (T1- 2) invasive breast carcinoma. After surgery and systemic treatment and when considering adjuvant radiation therapy, 310 cases received post mastectomy radiation therapy while 278 cases did not. Risk factors were identified for all cases which include; (1) medial site tumors, (2) size more than 4 cm, (3) premenopausal status (4) positive LVI (5) triple negative cases. cases with more than 2 risk factors were also examined in both groups to assess the effect of accumulated risk factors. Time of local failure if happened and duration of disease-free survival were reported. Results: Patients characteristics are matched between the 2 groups. At the end of the study, 18 cases (5.8%) in group 1 developed local recurrence compared with 29 cases (10.4%) in group 2 with 0.039 P value. The incidence of LRR is higher in cases presented with risk factors specially when more than 2. Considering the effect of PMRT; disease free survival was better in all risky subgroups in group 1 compared to group 2. Although P value was not significant when assessing every risk factor alone, but it was significant when there were more than 2 risk factors (mean disease-free survival was 96.28 months in group 1 compared to 82.76 months in group 2 with 0.015 P value). Conclusion: we concluded that there are multiple risk factors for locoregional recurrence in early node-negative breast cancer patients after mastectomy. Cases presented with those factors (specially when more than 2) could have a benefit from post mastectomy radiation therapy | ||
| Keywords | ||
| early breast cancer; adjuvant radiotherapy; risk factors | ||
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