Impact of clinical-pathological factors on locoregional recurrence in mastectomy patients with T1-2N1 breast cancer: who can omit adjuvant radiotherapy?

Purpose Postmastectomy radiation therapy (PMRT) in T1–T2 tumors with 1–3 positive axillary lymph nodes (ALNs) is controversial. This study was to identify prognostic factors of locoregional control (LRC) following mastectomy with or without PMRT for patients with T1-2N1 breast cancer and to discuss the selection of patients who might omit PMRT. Materials and methods Between January 2006 and December 2012, the data of 1474 postmastectomy patients staged pT1-2N1 were analyzed. PMRT was applied in 663 patients. LRC and disease-free survival (DFS) were calculated using the Kaplan–Meier method. Cox regression model was applied in the univariate and multivariate analyses to recognize the recurrence risk factors. Results With the median follow-up duration of 93 months (range, 5–168 months), 78 patients (5.3%) failed to secure LRC and 220 patients (14.9%) experienced any recurrence. The 7.7-year LRC and DFS was 94.9% and 85.4% respectively in the entire cohort. PMRT significantly improved 7.7-year LRC from 93.4% to 96.6% ( p = 0.005), but not the DFS ( p = 0.335). Multivariate analysis revealed that PMRT was an independent prognostic factor of LRC ( p