Axillary Radiotherapy in Conservative Surgery for Early-Stage Breast Cancer (Stage I and II)

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• 作者：Alejandra Garcí ; a Novoa^a ; ^{mag_1406@hotmail.com" class="auth_mail" title="E-mail the corresponding author} ; Benigno Acea Nebril^a ; Inma Dí ; az^b ; Sergio Builes Ramí ; rez^a ; Cristina Varela^a ; Carmen Cereijo^a ; Joaquí ; n Mosquera Oses^a ; Beatriz Ló ; pez Calviñ ; o^c ; Marí ; a Teresa Seoane Pillado^c
• 关键词：Breast cancer ; Axillary lymph node dissection ; Axillary radiotherapy ; Axillary relapse ; Breast conserving surgery
• 刊名：Cirugía Española (English Edition)
• 出版年：2016
• 出版时间：June-July 2016
• 年：2016
• 卷：94
• 期：6
• 页码：331-338
• 全文大小：523 K

文摘

Several clinical studies analyze axillary treatment in women with early-stage breast cancer because of changes in the indication for axillary lymph node dissection. The aim of the study is to analyze the impact of axillary radiotherapy in disease-free and overall survival in women with early breast cancer treated with lumpectomy.

Methods

Retrospective study in women with initial stages of breast carcinoma treated by lumpectomy. A comparative analysis of high-risk women with axillary lymph node involvement who received axillary radiotherapy with the group of women with low risk without radiotherapy was performed. Logistic regression was used to determine factors influencing survival and lymphedema onset.

Results

A total of 541 women were included in the study: 384 patients (71%) without axillary lymph node involvement and 157 women (29%) with 1-3 axillary lymph node involvement. Patients with axillary radiotherapy had a higher number of metastatic lymph node compared to non-irradiated (1.6 ± 0.7 vs 1.4 ± 0.6, P=.02). The group of women with axillary lymph node involvement and radiotherapy showed an overall and disease-free survival at 10 years similar to that obtained in patients without irradiation (89.7% and 77.2%, respectively). 3 lymph nodes involved multiplied by more than 7 times the risk of death (HR = 7.20; 95% CI: 1.36 to 38.12). The multivariate analysis showed axillary lymph node dissection as the only variable associated with the development of lymphedema.

Conclusion

The incidence of axillary relapse on stage I and II breast cancer is rare. In these patients axillary radiotherapy does not improve overall survival, but contributes to regional control in those patients with risk factors.