Abstract
626 Background: To determine the incidence and risk factors for local-regional failure (LRR) and to evaluate the indications for nodal irradiation in patients with stage I-II breast cancer. Methods: A total of 3,960 cases of stage pT1-pT2 breast cancer were treated with breast-conserving therapy at University of Florence. The lymph nodes were pathologically involved in 29% of patients, 19.7% with one to three positive nodes (PAN) and 9.3% with more than three PAN. All patients received whole breast irradiation without nodal irradiation. Results: The 3, 5 and 10 years actuarial rates for any LRR were 2.3%, 4.3% and 7.4%, respectively. While the 3, 5 and 10 years actuarial recurrence rates for nodal relapse (NR) were 1.0%, 2.0% and 2.0%, respectively. We found that the most common site for LRR was breast (3.9%) and that NR occurred in 1.3% of patients. In the multivariate analysis for NR, angiolymphatic invasion, pT2 and more than three PAN were statistically significant. Anyhow, NR was the only site of recurrence in a very small percentage of patients with more than three PAN. Conclusions: Concerning patients with negative or one to three PAN, there is no indication for nodal irradiation. But also in case of patients with more than three PAN our data suggest that a routine node irradiation is not justified. No significant financial relationships to disclose.
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