Journal article
Patterns and risk factors for locoregional failures after mastectomy for breast cancer: an International Breast Cancer Study Group report.
- Karlsson P Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden. Electronic address: per.karlsson@oncology.gu.se.
- Cole BF Department of Mathematics and Statistics College of Engineering and Mathematical Sciences, University of Vermont, Burlington; IBCSG Statistical Center, Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston, USA.
- Chua BH Department of Radiation Oncology, Peter MacCallum Cancer Centre and University of Melbourne, Melbourne, Australia.
- Price KN IBCSG Statistical Center, Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston, USA; Frontier Science and Technology Research Foundation, Boston, USA.
- Lindtner J The Institute of Oncology, Ljubljana, Slovenia.
- Collins JP Department of Surgery, Royal Melbourne Hospital, Victoria, Australia.
- Kovács A Department of Pathology, Sahlgrenska University Hospital, Gothenburg, Sweden.
- Thürlimann B The Breast Center, Kantonsspital, St Gallen, Switzerland and Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland.
- Crivellari D Department of Medical Oncology, Centro di Riferimento Oncologico, Aviano, Italy.
- Castiglione-Gertsch M Gyneco-Oncology Unit, University Hospital, Geneva, Switzerland.
- Forbes JF Australian New Zealand Breast Cancer Trials Group, University of Newcastle, Calvary Mater Newcastle, Newcastle, Australia.
- Gelber RD IBCSG Statistical Center, Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston, USA; Frontier Science and Technology Research Foundation, Boston, USA; Harvard School of Public Health and Harvard Medical School, Boston, USA.
- Goldhirsch A European Institute of Oncology, Milan, Italy; Swiss Center for Breast Health, Sant'Anna Clinics, Lugano-Sorengo.
- Gruber G Institut fuer Radiotherapie, Klinik Hirslanden, Zürich, Switzerland.
- 2012-07-11
Published in:
- Annals of oncology : official journal of the European Society for Medical Oncology. - 2012
Adult
Axilla
Breast Neoplasms
Female
Humans
Lymph Node Excision
Lymph Nodes
Lymphatic Metastasis
Mastectomy
Middle Aged
Neoplasm Recurrence, Local
Radiotherapy, Adjuvant
Receptors, Estrogen
Risk Factors
Treatment Failure
English
BACKGROUND
Rates and risk factors of local, axillary and supraclavicular recurrences can guide patient selection and target for postmastectomy radiotherapy (PMRT).
PATIENTS AND METHODS
Local, axillary and supraclavicular recurrences were evaluated in 8106 patients enrolled in 13 randomized trials. Patients received chemotherapy and/or endocrine therapy and mastectomy without radiotherapy. Median follow-up was 15.2 years.
RESULTS
Ten-year cumulative incidence for chest wall recurrence of >15% was seen in patients aged <40 years (16.1%), with ≥4 positive nodes (16.5%) or 0-7 uninvolved nodes (15.1%); for supraclavicular failures >10%: ≥4 positive nodes (10.2%); for axillary failures of >5%: aged <40 years (5.1%), unknown primary tumor size (5.2%), 0-7 uninvolved nodes (5.2%). In patients with 1-3 positive nodes, 10-year cumulative incidence for chest wall recurrence of >15% were age <40, peritumoral vessel invasion or 0-7 uninvolved nodes. Age, number of positive nodes and number of uninvolved nodes were significant parameters for each locoregional relapse site.
CONCLUSION
PMRT to the chest wall and supraclavicular fossa is supported in patients with ≥4 positive nodes. With 1-3 positive nodes, chest wall PMRT may be considered in patients aged <40 years, with 0-7 uninvolved nodes or with vascular invasion. The findings do not support PMRT to the dissected axilla.
Rates and risk factors of local, axillary and supraclavicular recurrences can guide patient selection and target for postmastectomy radiotherapy (PMRT).
PATIENTS AND METHODS
Local, axillary and supraclavicular recurrences were evaluated in 8106 patients enrolled in 13 randomized trials. Patients received chemotherapy and/or endocrine therapy and mastectomy without radiotherapy. Median follow-up was 15.2 years.
RESULTS
Ten-year cumulative incidence for chest wall recurrence of >15% was seen in patients aged <40 years (16.1%), with ≥4 positive nodes (16.5%) or 0-7 uninvolved nodes (15.1%); for supraclavicular failures >10%: ≥4 positive nodes (10.2%); for axillary failures of >5%: aged <40 years (5.1%), unknown primary tumor size (5.2%), 0-7 uninvolved nodes (5.2%). In patients with 1-3 positive nodes, 10-year cumulative incidence for chest wall recurrence of >15% were age <40, peritumoral vessel invasion or 0-7 uninvolved nodes. Age, number of positive nodes and number of uninvolved nodes were significant parameters for each locoregional relapse site.
CONCLUSION
PMRT to the chest wall and supraclavicular fossa is supported in patients with ≥4 positive nodes. With 1-3 positive nodes, chest wall PMRT may be considered in patients aged <40 years, with 0-7 uninvolved nodes or with vascular invasion. The findings do not support PMRT to the dissected axilla.
- Language
-
- English
- Open access status
- bronze
- Identifiers
-
- DOI 10.1093/annonc/mds118
- PMID 22776708
- Persistent URL
- https://sonar.ch/global/documents/232860
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