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Yin H, Qu Y, Wang X, Ma T, Zhang H, Zhang Y, Li Y, Zhang S, Ma H, Xing E, Liu X, Xu Q. Impact of postmastectomy radiation therapy in T1-2 breast cancer patients with 1-3 positive axillary lymph nodes. Oncotarget 2018; 8:49564-49573. [PMID: 28484094 PMCID: PMC5564788 DOI: 10.18632/oncotarget.17318] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Accepted: 03/31/2017] [Indexed: 11/25/2022] Open
Abstract
The effect of postmastectomy radiotherapy (PMRT) on T1-2 breast cancer patients with 1-3 positive axillary lymph nodes is controversial up to now. The purpose of this study was to evaluate the impact of postmastectomy radiotherapy for these patients. The prognostic factor effecting locoregional free-survival (LRFS) was also analyzed. In the retrospective clinical data of 1674 eligible patients, survival analysis was performed using the method of Kaplan-Meier and the log-rank test. Cox regression analysis was applied to identify the significant prognostic factors. We found PMRT increased 5-year LRFS (p=0.003), but could not improve 5-year disease-free survival or overall survival statistically. For patients without PMRT, multivariate analysis revealed that age, lymph node ratio and molecule subtype were risk factors effecting LRFS. To further analyze the role of PMRT, we grouped all the patients into low risk group (0 or 1 risk factor) and high risk group (2 or 3 risk factors) depending on these risk factors. We found that in low-risk group, PMRT increased only 5-year LRFS (p=0.012). However, in high-risk group, PMRT increased both 5-year LRFS (p=0.005) and 5-year disease-free survival (p=0.033), but could not improve 5-year overall survival statistically. Thus, these data provide the evidence that PMRT could improve LRFS for T1-2 breast cancer patients with 1-3 positive axillary lymph nodes. Additionally, PMRT could improve LRFS and disease-free survival for high risk patients. Age, lymph node ratio and molecule subtype were high risk factors effecting LRFS in our study.
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Affiliation(s)
- Hang Yin
- The Department of Breast Radiotherapy, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang Province, China
| | - Yuanyuan Qu
- The Department of Breast Radiotherapy, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang Province, China
| | - Xiaoyuan Wang
- The Department of Internal Medical Oncology, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang Province, China
| | - Tengchuang Ma
- The Department of Nuclear Medicine, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang Province, China
| | - Haiyang Zhang
- The Department of General Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang Province, China
| | - Yu Zhang
- The Department of Breast Radiotherapy, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang Province, China
| | - Yang Li
- The Department of Breast Radiotherapy, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang Province, China
| | - Siliang Zhang
- The Department of Breast Radiotherapy, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang Province, China
| | - Hongyu Ma
- The Department of Breast Radiotherapy, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang Province, China
| | - Enkang Xing
- The Department of Breast Radiotherapy, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang Province, China
| | - Xueying Liu
- The Department of Breast Radiotherapy, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang Province, China
| | - Qingyong Xu
- The Department of Breast Radiotherapy, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang Province, China
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Discussion: Molecular Profiling Using Breast Cancer Subtype to Plan for Breast Reconstruction. Plast Reconstr Surg 2017; 139:597e-598e. [PMID: 28234814 DOI: 10.1097/prs.0000000000003096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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