Outcomes in Patients with pT3N0M0 Breast Cancer with and without Postmastectomy Radiotherapy

Chunyan Li; Jiangfeng Wang; Miao Mo; Jing Yuan; Jurui Luo; Kairui Jin; Xuanyi Wang; Yilan Yang; Jinli Ma; Xin Mei; Zhaozhi Yang; Xiaoli Yu; Xingxing Chen; Xiaomao Guo

doi:10.2147/CMAR.S309224

Outcomes in Patients with pT3N0M0 Breast Cancer with and without Postmastectomy Radiotherapy

Cancer Manag Res. 2021 May 13:13:3889-3899. doi: 10.2147/CMAR.S309224. eCollection 2021.

Authors

Chunyan Li^{1

2}, Jiangfeng Wang^{1

2}, Miao Mo^{2

3}, Jing Yuan^{2

3}, Jurui Luo^{1

2}, Kairui Jin^{1

2}, Xuanyi Wang^{1

2}, Yilan Yang^{1

2}, Jinli Ma^{1

2}, Xin Mei^{1

2}, Zhaozhi Yang^{1

2}, Xiaoli Yu^{1

2}, Xingxing Chen^{1

2}, Xiaomao Guo^{1

2}

Affiliations

¹ Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, 200032, People's Republic of China.
² Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, People's Republic of China.
³ Department of Cancer Prevention, Fudan University Shanghai Cancer Center, Shanghai, 200032, People's Republic of China.

Abstract

Purpose: The role of adjuvant postmastectomy radiotherapy (PMRT) remains controversial for patients with pT3N0M0 breast cancer, especially when patients are treated with the updated adjuvant chemotherapy. Our study aimed to compare locoregional recurrence-free survival (LRFS), disease-free survival (DFS), and breast cancer-specific survival (BCSS) in pT3N0M0 patients with and without postmastectomy radiotherapy.

Patients and methods: Between October 2000 and 8 September 2016, the database of the Breast Cancer Center of Shanghai yielded 114 patients with node-negative non-metastatic breast cancer larger than 5 cm. Univariate and multivariate analyses were performed to assess the risk factors for survivals. Differences between the two groups were compared using the Log rank test.

Results: Fifty-nine (51.8%) of the patients received adjuvant PMRT. The median follow-up was 62.3 months. Five-year LRFS was 100% in the PMRT group vs 98.1% in the non-PMRT group (P=0.17); 5-year DFS was 97.1% for the entire cohort, 98.0% for the PMRT group vs 96.2% for the non-PMRT group (P=0.18). Univariate analysis identified that family history of malignant tumors, lymphovascular invasion (LVI), or triple-negative breast cancer (TNBC) molecular subtype were associated with higher locoregional recurrence (LRR) (P<0.05). No PMRT was the only risk factor independently associated with poorer DFS (P=0.048) on multivariate analysis. No difference in BCSS was observed between the two groups.

Conclusion: The present study demonstrated a low LRR rate and good survival for node-negative breast cancer >5 cm. Patients with family history of malignant tumors, TNBC subtype, LVI positivity, or grade 3 disease are at high risk for LRR and might benefit from PMRT.

Keywords: locoregional recurrence; node-negative; radiotherapy; updated systemic treatment.

Grants and funding

The collection, analysis, and interpretation of the data in this paper were supported by the National Natural Science Foundation of China (grant number 8197110875, 81602668), the Shanghai Youth Medical Talents-Specialist Program.