- 作者：Marco Trovo ; M.D.&lowast ; ; marcotrovo33@hotmail.com ; Elena Durofil ; R.T.T.&lowast ; ; Jerry Polesel ; Sc.D.&dagger ; ; Mario Roncadin ; M.D.&lowast ; ; Tiziana Perin ; M.D.&Dagger ; ; Mario Mileto ; M.D.§ ; ; Erica Piccoli ; M.D.§ ; ; Daniela Quitadamo ; Sc.D.¶ ; ; Samuele Massarut ; M.D.§ ; ; Antonino Carbone ; M.D.&Dagger ; ; Mauro G. Trovo ; M.D.&lowast ;
- 关键词：Postmastectomy irradiation ; Early breast cancer ; Risk factors ; Local recurrence ; Pattern of failure
- 刊名：International Journal of Radiation Oncology*Biology*Physics
- 出版年：2012
- 期刊代码：136_03603016
- 类别：med
- 出版时间：1 June, 2012
- 卷：83
- 期：2
- 页码：e153-e157
- 文件大小：229 K
Purpose
To assess the locoregional failure in patients with Stage I-II breast cancer treated with radical mastectomy and to evaluate whether a subset of these patients might be at sufficiently high risk of locoregional recurrence (LRR) to benefit from postmastectomy irradiation (PMRT).Methods and Materials
Stage I-II breast cancer patients (n = 150) treated with radical mastectomy without adjuvant irradiation between 1999 and 2005 were analyzed. The pattern of LRR was reported. Kaplan-Meier analysis was used to calculate rates of LRR, and Cox proportional hazards methods were used to evaluate potential risk factors.
Results
Median follow-up was 75 months. Mean patient age was 56 years. One-hundred forty-three (95%) patients received adjuvant systemic therapy: 85 (57%) hormonal therapy alone, 14 (9%) chemotherapy alone, and 44 (29%) both chemotherapy and hormonal therapy. Statistically significant factors associated with increased risk of LRR were premenopausal status (p = 0.004), estrogen receptor negative cancer (p = 0.02), pathologic grade 3 (p = 0.02), and lymphovascular invasion (p = 0.001). T and N stage were not associated with increased risk of regional recurrence. The 5-year LRR rate for patients with zero or one, two, three, and four risk factors was 1%, 10.3%, 24.2%, and 75%, respectively.
Conclusions
A subset of patients with early-stage breast cancer is at high risk of LRR, and therefore PMRT might be beneficial.