Locoregional recurrence risk factors in breast cancer patients with positive axillary lymph nodes and the impact of postmastectomy radiotherapy
Background Locoregional recurrence (LRR) after mastectomy reduces the patient’s quality of life and survival. There is a consensus that postmastectomy radiotherapy (PMRT) helps establish locoregional control and reduces LRR in patients with ≥4 metastatic nodes. However, in patients with 1–3 metastat...
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| Veröffentlicht in: | International journal of clinical oncology 2013-02, Vol.18 (1), p.54-61 |
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| creator | Nagao, Tomoya Kinoshita, Takayuki Tamura, Nobuko Hojo, Takashi Morota, Madoka Kagami, Yoshikazu |
| description | Background
Locoregional recurrence (LRR) after mastectomy reduces the patient’s quality of life and survival. There is a consensus that postmastectomy radiotherapy (PMRT) helps establish locoregional control and reduces LRR in patients with ≥4 metastatic nodes. However, in patients with 1–3 metastatic nodes, the incidence of LRR and the role of PMRT have been the subject of substantial controversy. This study assessed the risk factors for LRR and the efficacy of PMRT in Japanese breast cancer patients with metastatic nodes.
Methods
This study analyzed 789 cases of invasive breast carcinoma with metastatic nodes from 1998 to 2008. We divided the study population into 4 groups: 1–3 positive nodes with/without chemotherapy and ≥4 positive nodes with/without chemotherapy. Risk factors for LRR were identified and the relationship between LRR and PMRT was analyzed.
Results
During the median follow-up of 59.6 months, 61 (7.7%) patients experienced LRR. In patients who received chemotherapy, independent LRR risk factors were high nuclear grade, severe lymphatic invasion, vascular invasion, and progesterone receptor-negative status in patients with 1–3 positive nodes, and severe lymphatic invasion and estrogen receptor-negative status in patients with ≥4 nodes. Although patients treated with PMRT had good outcomes, there was no significant difference, and PMRT did not significantly improve the outcome of the patients with all risk factors.
Conclusions
With systemic therapy and adequate dissection, PMRT by itself was of limited value in establishing locoregional control. The indication for PMRT in patients with 1–3 positive nodes remains controversial. |
| doi_str_mv | 10.1007/s10147-011-0343-y |
| format | Article |
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Locoregional recurrence (LRR) after mastectomy reduces the patient’s quality of life and survival. There is a consensus that postmastectomy radiotherapy (PMRT) helps establish locoregional control and reduces LRR in patients with ≥4 metastatic nodes. However, in patients with 1–3 metastatic nodes, the incidence of LRR and the role of PMRT have been the subject of substantial controversy. This study assessed the risk factors for LRR and the efficacy of PMRT in Japanese breast cancer patients with metastatic nodes.
Methods
This study analyzed 789 cases of invasive breast carcinoma with metastatic nodes from 1998 to 2008. We divided the study population into 4 groups: 1–3 positive nodes with/without chemotherapy and ≥4 positive nodes with/without chemotherapy. Risk factors for LRR were identified and the relationship between LRR and PMRT was analyzed.
Results
During the median follow-up of 59.6 months, 61 (7.7%) patients experienced LRR. In patients who received chemotherapy, independent LRR risk factors were high nuclear grade, severe lymphatic invasion, vascular invasion, and progesterone receptor-negative status in patients with 1–3 positive nodes, and severe lymphatic invasion and estrogen receptor-negative status in patients with ≥4 nodes. Although patients treated with PMRT had good outcomes, there was no significant difference, and PMRT did not significantly improve the outcome of the patients with all risk factors.
Conclusions
With systemic therapy and adequate dissection, PMRT by itself was of limited value in establishing locoregional control. The indication for PMRT in patients with 1–3 positive nodes remains controversial.</description><identifier>ISSN: 1341-9625</identifier><identifier>EISSN: 1437-7772</identifier><identifier>DOI: 10.1007/s10147-011-0343-y</identifier><identifier>PMID: 22068463</identifier><language>eng</language><publisher>Japan: Springer Japan</publisher><subject>Adult ; Aged ; Breast cancer ; Breast Neoplasms - drug therapy ; Breast Neoplasms - pathology ; Breast Neoplasms - radiotherapy ; Breast Neoplasms - surgery ; Cancer Research ; Clinical outcomes ; Female ; Humans ; Lymph Node Excision ; Lymph Nodes - pathology ; Lymph Nodes - radiation effects ; Lymphatic Metastasis - pathology ; Lymphatic system ; Mastectomy ; Mastectomy - adverse effects ; Medicine ; Medicine & Public Health ; Metastasis ; Middle Aged ; Neoplasm Recurrence, Local - pathology ; Oncology ; Original Article ; Quality of Life ; Radiation therapy ; Radiotherapy, Adjuvant ; Risk Factors ; Surgical Oncology ; Treatment Outcome</subject><ispartof>International journal of clinical oncology, 2013-02, Vol.18 (1), p.54-61</ispartof><rights>Japan Society of Clinical Oncology 2011</rights><rights>Japan Society of Clinical Oncology 2013</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c425t-f7bf8f34a7f6ce5796565c40c753f0c3a41e179ad56fbbc8a82cf4c3c20a44883</citedby><cites>FETCH-LOGICAL-c425t-f7bf8f34a7f6ce5796565c40c753f0c3a41e179ad56fbbc8a82cf4c3c20a44883</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10147-011-0343-y$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10147-011-0343-y$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22068463$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Nagao, Tomoya</creatorcontrib><creatorcontrib>Kinoshita, Takayuki</creatorcontrib><creatorcontrib>Tamura, Nobuko</creatorcontrib><creatorcontrib>Hojo, Takashi</creatorcontrib><creatorcontrib>Morota, Madoka</creatorcontrib><creatorcontrib>Kagami, Yoshikazu</creatorcontrib><title>Locoregional recurrence risk factors in breast cancer patients with positive axillary lymph nodes and the impact of postmastectomy radiotherapy</title><title>International journal of clinical oncology</title><addtitle>Int J Clin Oncol</addtitle><addtitle>Int J Clin Oncol</addtitle><description>Background
Locoregional recurrence (LRR) after mastectomy reduces the patient’s quality of life and survival. There is a consensus that postmastectomy radiotherapy (PMRT) helps establish locoregional control and reduces LRR in patients with ≥4 metastatic nodes. However, in patients with 1–3 metastatic nodes, the incidence of LRR and the role of PMRT have been the subject of substantial controversy. This study assessed the risk factors for LRR and the efficacy of PMRT in Japanese breast cancer patients with metastatic nodes.
Methods
This study analyzed 789 cases of invasive breast carcinoma with metastatic nodes from 1998 to 2008. We divided the study population into 4 groups: 1–3 positive nodes with/without chemotherapy and ≥4 positive nodes with/without chemotherapy. Risk factors for LRR were identified and the relationship between LRR and PMRT was analyzed.
Results
During the median follow-up of 59.6 months, 61 (7.7%) patients experienced LRR. In patients who received chemotherapy, independent LRR risk factors were high nuclear grade, severe lymphatic invasion, vascular invasion, and progesterone receptor-negative status in patients with 1–3 positive nodes, and severe lymphatic invasion and estrogen receptor-negative status in patients with ≥4 nodes. Although patients treated with PMRT had good outcomes, there was no significant difference, and PMRT did not significantly improve the outcome of the patients with all risk factors.
Conclusions
With systemic therapy and adequate dissection, PMRT by itself was of limited value in establishing locoregional control. The indication for PMRT in patients with 1–3 positive nodes remains controversial.</description><subject>Adult</subject><subject>Aged</subject><subject>Breast cancer</subject><subject>Breast Neoplasms - drug therapy</subject><subject>Breast Neoplasms - pathology</subject><subject>Breast Neoplasms - radiotherapy</subject><subject>Breast Neoplasms - surgery</subject><subject>Cancer Research</subject><subject>Clinical outcomes</subject><subject>Female</subject><subject>Humans</subject><subject>Lymph Node Excision</subject><subject>Lymph Nodes - pathology</subject><subject>Lymph Nodes - radiation effects</subject><subject>Lymphatic Metastasis - pathology</subject><subject>Lymphatic system</subject><subject>Mastectomy</subject><subject>Mastectomy - adverse effects</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Metastasis</subject><subject>Middle Aged</subject><subject>Neoplasm Recurrence, Local - pathology</subject><subject>Oncology</subject><subject>Original Article</subject><subject>Quality of Life</subject><subject>Radiation therapy</subject><subject>Radiotherapy, Adjuvant</subject><subject>Risk Factors</subject><subject>Surgical Oncology</subject><subject>Treatment Outcome</subject><issn>1341-9625</issn><issn>1437-7772</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp1kcuO1DAQRS0EYh7wAWxQSawDfsV2L9GIl9QSG1hbjlOe9pDEwXYD-Qp-Gbd6GLFhVZbq1Cm5LiEvGH3NKNVvCqNM6o4y1lEhRbc9IpdMCt1prfnj9haSdTvF-wtyVcodpUyrnj8lF5xTZaQSl-T3PvmU8TamxU2Q0R9zxsUj5Fi-QXC-plwgLjBkdKWCd62ZYXU14lIL_Iz1AGsqscYfCO5XnCaXN5i2eT3AkkYs4JYR6gEhzmvTQQonvs7Nhs0-b5DdGFMjslu3Z-RJcFPB5_f1mnx9_-7Lzcdu__nDp5u3-85L3tcu6CGYIKTTQXns9U71qveSet2LQL1wkiHTOzf2KgyDN85wH6QXnlMnpTHimrw6e9ecvh-xVHuXjrndoFjGjVGUa6Maxc6Uz6mUjMGuOc7tg5ZRe4rAniOwLQJ7isBubeblvfk4zDg-TPy9eQP4GSittdxi_mf1f61_AHCklg0</recordid><startdate>20130201</startdate><enddate>20130201</enddate><creator>Nagao, Tomoya</creator><creator>Kinoshita, Takayuki</creator><creator>Tamura, Nobuko</creator><creator>Hojo, Takashi</creator><creator>Morota, Madoka</creator><creator>Kagami, Yoshikazu</creator><general>Springer Japan</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope></search><sort><creationdate>20130201</creationdate><title>Locoregional recurrence risk factors in breast cancer patients with positive axillary lymph nodes and the impact of postmastectomy radiotherapy</title><author>Nagao, Tomoya ; Kinoshita, Takayuki ; Tamura, Nobuko ; Hojo, Takashi ; Morota, Madoka ; Kagami, Yoshikazu</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c425t-f7bf8f34a7f6ce5796565c40c753f0c3a41e179ad56fbbc8a82cf4c3c20a44883</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Breast cancer</topic><topic>Breast Neoplasms - drug therapy</topic><topic>Breast Neoplasms - pathology</topic><topic>Breast Neoplasms - radiotherapy</topic><topic>Breast Neoplasms - surgery</topic><topic>Cancer Research</topic><topic>Clinical outcomes</topic><topic>Female</topic><topic>Humans</topic><topic>Lymph Node Excision</topic><topic>Lymph Nodes - pathology</topic><topic>Lymph Nodes - radiation effects</topic><topic>Lymphatic Metastasis - pathology</topic><topic>Lymphatic system</topic><topic>Mastectomy</topic><topic>Mastectomy - adverse effects</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Metastasis</topic><topic>Middle Aged</topic><topic>Neoplasm Recurrence, Local - pathology</topic><topic>Oncology</topic><topic>Original Article</topic><topic>Quality of Life</topic><topic>Radiation therapy</topic><topic>Radiotherapy, Adjuvant</topic><topic>Risk Factors</topic><topic>Surgical Oncology</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Nagao, Tomoya</creatorcontrib><creatorcontrib>Kinoshita, Takayuki</creatorcontrib><creatorcontrib>Tamura, Nobuko</creatorcontrib><creatorcontrib>Hojo, Takashi</creatorcontrib><creatorcontrib>Morota, Madoka</creatorcontrib><creatorcontrib>Kagami, Yoshikazu</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><jtitle>International journal of clinical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Nagao, Tomoya</au><au>Kinoshita, Takayuki</au><au>Tamura, Nobuko</au><au>Hojo, Takashi</au><au>Morota, Madoka</au><au>Kagami, Yoshikazu</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Locoregional recurrence risk factors in breast cancer patients with positive axillary lymph nodes and the impact of postmastectomy radiotherapy</atitle><jtitle>International journal of clinical oncology</jtitle><stitle>Int J Clin Oncol</stitle><addtitle>Int J Clin Oncol</addtitle><date>2013-02-01</date><risdate>2013</risdate><volume>18</volume><issue>1</issue><spage>54</spage><epage>61</epage><pages>54-61</pages><issn>1341-9625</issn><eissn>1437-7772</eissn><abstract>Background
Locoregional recurrence (LRR) after mastectomy reduces the patient’s quality of life and survival. There is a consensus that postmastectomy radiotherapy (PMRT) helps establish locoregional control and reduces LRR in patients with ≥4 metastatic nodes. However, in patients with 1–3 metastatic nodes, the incidence of LRR and the role of PMRT have been the subject of substantial controversy. This study assessed the risk factors for LRR and the efficacy of PMRT in Japanese breast cancer patients with metastatic nodes.
Methods
This study analyzed 789 cases of invasive breast carcinoma with metastatic nodes from 1998 to 2008. We divided the study population into 4 groups: 1–3 positive nodes with/without chemotherapy and ≥4 positive nodes with/without chemotherapy. Risk factors for LRR were identified and the relationship between LRR and PMRT was analyzed.
Results
During the median follow-up of 59.6 months, 61 (7.7%) patients experienced LRR. In patients who received chemotherapy, independent LRR risk factors were high nuclear grade, severe lymphatic invasion, vascular invasion, and progesterone receptor-negative status in patients with 1–3 positive nodes, and severe lymphatic invasion and estrogen receptor-negative status in patients with ≥4 nodes. Although patients treated with PMRT had good outcomes, there was no significant difference, and PMRT did not significantly improve the outcome of the patients with all risk factors.
Conclusions
With systemic therapy and adequate dissection, PMRT by itself was of limited value in establishing locoregional control. The indication for PMRT in patients with 1–3 positive nodes remains controversial.</abstract><cop>Japan</cop><pub>Springer Japan</pub><pmid>22068463</pmid><doi>10.1007/s10147-011-0343-y</doi><tpages>8</tpages></addata></record> |
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| identifier | ISSN: 1341-9625 |
| ispartof | International journal of clinical oncology, 2013-02, Vol.18 (1), p.54-61 |
| issn | 1341-9625 1437-7772 |
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| subjects | Adult Aged Breast cancer Breast Neoplasms - drug therapy Breast Neoplasms - pathology Breast Neoplasms - radiotherapy Breast Neoplasms - surgery Cancer Research Clinical outcomes Female Humans Lymph Node Excision Lymph Nodes - pathology Lymph Nodes - radiation effects Lymphatic Metastasis - pathology Lymphatic system Mastectomy Mastectomy - adverse effects Medicine Medicine & Public Health Metastasis Middle Aged Neoplasm Recurrence, Local - pathology Oncology Original Article Quality of Life Radiation therapy Radiotherapy, Adjuvant Risk Factors Surgical Oncology Treatment Outcome |
| title | Locoregional recurrence risk factors in breast cancer patients with positive axillary lymph nodes and the impact of postmastectomy radiotherapy |
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