Post Mastectomy Radiation for Stage II Breast Cancer Patients with T1/T2 Lesions
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Original Article
P: 71-75
April 2019

Post Mastectomy Radiation for Stage II Breast Cancer Patients with T1/T2 Lesions

Eur J Breast Health 2019;15(2):71-75
1. Department of General Surgery, Miami University School of Medicine, Miami, USA
2. Department of Radiation Oncology, Miami University School of Medicine, Miami, USA
No information available.
No information available
Received Date: 14.11.2018
Accepted Date: 21.02.2019
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ABSTRACT

Objective:

Post mastectomy radiation (PMR) is usually recommended for T3 or N2 breast cancer (BC). The role of PMR for stage II BC with T1/ T2 lesions remains controversial. The aim of this study was to assess the role of PMR in this subgroup of patients.

Materials and Methods:

A retrospective analysis of a prospectively collected database of all stage II BC patients treated with mastectomy at our institution between the years 2005-2008 was performed. Demographics, disease-free survival rates were compared between the patients receiving radiation vs. those who were not irradiated.

Results:

Eighty-two patients underwent mastectomies for stage II disease with a T1/T2 lesion. Twenty-two of those (27%) received PMR. Loco regional recurrence (LRR) occurred only in the non -irradiated (NR) group. A Kaplan Meier analysis of time to LRR in the NR group was performed. Mean time to local failure was 78.9 months, 6% at 3 years and 13% at 5 years. The time to LRR was significantly lower in the estrogen receptor (ER) negative group compared to the ER positive group (64 vs. 82 months, p=0.029). LRR free rate at 5 years was 100% in low grade tumors vs. 53% in high grade tumors, (p=0.001). In a Cox regression multivariate analysis none of those factors maintained significance.

Conclusion:

ER negative status, high grade and node negativity were associated with LRR. A prospective trial randomizing stage II BC patients with T1/T2 lesions, negative hormone receptors and high-grade tumors to PMR following mastectomy arm vs. no radiation arm is recommended.

Keywords:
Breast cancer, mastectomy, radiation