Abstract
There is consensus on the routine use of postmastectomy radiotherapy (PMRT) in patients with four or more positive axillary lymph nodes. However, the benefits of PMRT in patients with T1-2 and 1-3 involved lymph nodes still remain controversial. Data from the Surveillance, Epidemiology, and End Results Program (SEER) of the United States between 2010 and 2012 were used to analyze the outcomes of 675 triple-negative breast cancer (TNBC) patients with T1-2 and 1-3 lymph nodes involved. Those patients were subdivided into radiotherapy (RT) (312) and no-RT groups (363). After a median follow-up time of 37 months, Kaplan-Meier analysis showed that PMRT significantly improved overall survival (OS) but not breast cancer-specific survival (BCSS) in the total cohort of 675 patients (P=0.033 and P=0.063). And it was demonstrated that PMRT were independently associated with increased OS according to univariate and multivariate analyses. However, no significant differences in BCSS or OS were observed between the groups stratified by the number of positive lymph nodes. In conclusion, PMRT significantly improved OS for TNBC patients with T1-2 and 1-3 lymph nodes involved. Additional prospective studies are needed to provide a stronger evidence base for choosing patients for PMRT.
Highlights
Breast cancer is a highly heterogeneous disease, which is reflected in different clinical, pathologic, and molecular features
We tried to investigate the effect of postmastectomy radiotherapy (PMRT) on breast cancerspecific survival (BCSS) and overall survival (OS) among triple-negative breast cancer (TNBC) patients with T1-2 and 1-3 positive lymph nodes utilizing populationbased SEER data
This is the first study to show the difference of OS in such patients, while adjuvant radiotherapy has been reported to contribute to local-regional disease control in previous studies
Summary
Breast cancer is a highly heterogeneous disease, which is reflected in different clinical, pathologic, and molecular features. Postmastectomy radiotherapy (PMRT) is considered a standard treatment for high-risk breast cancers patients www.oncotarget.com with involvement of more than four positive axillary lymph nodes [7, 8]. It still remains controversial for patients with 1-3 lymph nodes to receive radiotherapy (RT). A meta-analysis of 22 randomized trials from Early Breast Cancer Trial list’s Collaboration Group (EBCTCG) in 2014 revealed that PMRT could reduce 10-year locoregional recurrence and 20-year breast cancer mortality for patients with one to three positive axillary lymph nodes [6]. No information about breast cancer molecular subtypes was presented in these studies
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