Abstract
BackgroundThe value of postmastectomy radiotherapy (PMRT) for pathological node-positive triple-negative breast cancers (TNBC) remains debatable. The aim of this population-based retrospective study was to evaluate the effect of PMRT on survival outcomes in this population.MethodsPatients diagnosed with stage T1-4N1-N3M0 TNBC between 2010 and 2014 were identified from the Surveillance, Epidemiology, and End Results (SEER) database. We used univariate and multivariate Cox regression hazards method to determine the independent prognostic factors associated with 3-year breast cancer-specific survival (BCSS). The effect of PMRT on 3-year BCSS was analyzed after stratification by pathological staging of groups.ResultsOf the 4398 patients included in this study, 2649 (60.2%) received PMRT. Younger age, black ethnicity, and advanced tumor (T) and nodal (N) stage were the independent predictors associated with PMRT receipt (all P < 0.05). Patients who received PMRT showed better 3-year BCSS (OR = 0.720, 95% CI = 0.642–0.808, P < 0.001) than those that did not. The effect of PMRT on 3-year BCSS was analyzed after stratification by pathological staging of groups. The results showed that PMRT was associated with better 3-year BCSS in patients with stage T3–4N1 (P = 0.042), T1-4N2 (P < 0.001), and T1-4N3 (P < 0.001), while comparable 3-year BCSS was found between the PMRT and non-PMRT cohorts with T1–2N1 disease (P = 0.191).ConclusionsRadiotherapy achieved better 3-year BCSS in TNBC patients with stage T3–4N1 and T1-4N2–3 disease. However, no survival benefit was found with the addition of PMRT in patients with T1–2N1 TNBC.
Highlights
The value of postmastectomy radiotherapy (PMRT) for pathological node-positive triple-negative breast cancers (TNBC) remains debatable
In the PMRT group, age < 50 years (41.4% vs. 35.2%), black ethnicity (22.7% vs. 19.8%), and T3 (21.1% vs. 15.7%) and T4 (16.4% vs. 10.2%) stages showed a higher proportion of acceptance rate, while T1 (15.9% vs. 26.5%) and T2 (46.7% vs. 47.6%) stages showed a lower proportion of acceptance rate than in the non-PMRT group
Our results showed that PMRT could provide significant benefits to 3-year breast cancer-specific survival (BCSS) for TNBC patients in T1-4N2 and T1-4N3 stages; TNBC patients with pathological T3–4N1 stage disease are more suitable for PMRT considering the results of multivariate analysis have more accuracy than the Kaplan–Meier analysis
Summary
The value of postmastectomy radiotherapy (PMRT) for pathological node-positive triple-negative breast cancers (TNBC) remains debatable. The aim of this population-based retrospective study was to evaluate the effect of PMRT on survival outcomes in this population. Enhancing survival outcome by multidisciplinary comprehensive treatment remains the global focus of breast cancer. The treatment of breast cancer is based on the T and N stages of patients and on the status of estrogen receptor (ER), progesterone receptor, and human epidermal growth factor receptor-2 (HER-2). Breast cancer subtypes based on ER, PR, and HER-2 have been widely used. TNBC has a higher risk of early metastasis, local recurrence, and poorer prognosis than other types of breast cancer [3]
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