Abstract
Objectives The indications for post-mastectomy radiotherapy (PMRT) with T1-2 breast cancer and 1-3 positive axillary lymph nodes is still controversial. The purpose of this study was to investigate the role of PMRT in T1-2 breast cancer with 1-3 positive axillary lymph node. Methods We retrospectively reviewed the file records of 79 patients receiving PMRT and not receiving PMRT (618 patients). Results The median follow-up was 65 months. Multivariate analysis showed that PMRT was an independent prognostic factor of locoregional recurrence-free survival (LRFS) (P = 0.010). Subgroup analysis of patients who did not undergo PMRT showed that pT stage, number of positive axillary lymph nodes, and molecular subtype were independent prognostic factors of LRFS. PMRT improved LRFS in the entire group (P = 0.005), but did not affect distant metastasis-free survival (DMFS) (P = 0.494), disease-free survival (DFS) (P = 0.215), and overall survival (OS) (P = 0.645). For patients without PMRT, the 5-year LRFS of low-risk patients (0–1 risk factor for locoregional recurrence) of 94.5% was significantly higher than that of high-risk patients (2-3 risk factors for locoregional recurrence) (80.9%, P < 0.001). PMRT improved LRFS (P = 0.001) and DFS (P = 0.027) in high-risk patients, but did not improve LRFS, DMFS, DFS, and OS in low-risk patients. Conclusions PMRT is beneficial in patients with high risk of locoregional recurrence breast cancer patients with T1-2 and 1 to 3 positive nodes.
Highlights
The reported study [1] is similar in aim and approach to another previously published study by some of the same authors: “The clinical value of adjuvant radiotherapy in patients with early stage breast cancer with 1 to 3 positive lymph nodes after mastectomy,” published in the Chinese Journal of Cancer [2]
In the PLOS ONE paper, patients receiving treatment from July 1998 to November 2007 were included in the study (79 patients received postmastectomy radiotherapy (PMRT); 618 patients did not receive PMRT)
The PLOS ONE study [1] included patients who received mastectomy at other hospitals followed by adjuvant therapy at Sun Yat-Sen University Cancer Center and patients who received comprehensive therapy at other hospitals but were followed up at Sun Yat-Sen University Cancer Center
Summary
The reported study [1] is similar in aim and approach to another previously published study by some of the same authors:. The reported study [1] is similar in aim and approach to another previously published study by some of the same authors: “The clinical value of adjuvant radiotherapy in patients with early stage breast cancer with 1 to 3 positive lymph nodes after mastectomy,” published in the Chinese Journal of Cancer [2]. This previous work was cited as reference number 20 in the PLOS ONE paper.
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