Local recurrence pattern of pT1-2N1 breast cancer after modified radical mastectomy —a pooled-analysis of 5442 patients from 12 centers
Guo Xinyuan1, Zhang Yujing2, Zhang Na3, Tang Yu1, Zhao Xuran1, Jing Hao1, Fang Hui1, Wen Ge2,4, Cheng Jing5, Shi Mei6, Guo Qishuai7, Wu Hongfen8, Wang Xiaohu9, Ma Changying10, Li Yexiong1, Wang Hongmei11, Liu Min12, Wang Shulian1
1Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China; 2Department of Radiation Oncology, First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China; 3Department of Radiation Oncology, Liaoning Cancer Hospital, Shenyang 110801, China; 4Department of Radiation Oncology, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou 510150, China; 5Department of Breast Oncology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China; 6Department of Radiation Oncology, Xijing Hospital, Affiliated to Air Force Military Medical University, Xi'an 710032, China; 7Department of Radiation Oncology, Affiliated Cancer Hospital of Chongqing University, Chongqing 400030, China; 8Department of Radiation Oncology, Jilin Cancer Hospital, Changchun 130012, China; 9Department of Radiation Oncology, Gansu Cancer Hospital, Lanzhou 730050, China; 10Department of Radiation Oncology, Qiqihar First Hospital, Qiqihar 161055, China; 11Department of Radiation Oncology, First School of Clinical Medicine, Southern Medical University, Guangzhou 510515, China; 12Department of Radiation Oncology, First Hospital of Jilin University, Changchun 130061, China
Abstract：Objective To analyze locoregional recurrence (LRR) pattern of patients with pT1-2N1 breast cancer after modified radical mastectomy, with and without adjuvant radiotherapy (RT). Methods A total of 5442 eligible patients with breast cancer from 12 Chinese centers were included. The LRR sites and the effect of RT at different sites on recurrence in patients with and without RT were analyzed. The Kaplan-Meier method was used to calculate the cumulative LRR rate, and the difference was compared by the log-rank test. Results With a median follow-up time of 63.8 months for the entire cohort, 395 patients developed LRR. The chest wall and supraclavicular fossa were the most common LRR sites, regardless of RT or molecular subtypes. The 5-year chest wall recurrence rates for patients with and without chest wall irradiation were 2.5% and 3.8%(P=0.003);the 5-year supraclavicular lymph nodal recurrence rates for patients with and without supraclavicular fossa irradiation were 1.3% and 4.1%(P<0.001);the 5-year axillary recurrence-free rates for patients with and without axillary irradiation were 0.8% and 1.5%(HR=0.31, 95%CI:0.04-2.23, P=0.219);and the 5-year internal mammary nodal recurrence-free rates for patients with and without internal mammary nodal irradiation were 0.8% and 1.5%(HR=0.45, 95%CI:0.11-1.90, P=0.268). Conclusions The chest wall and supraclavicular fossa are the most common LRR sites of patients with pT1-2N1 breast cancer after modified radical mastectomy, which is not affected by adjuvant RT or molecular subtypes. The chest wall and supraclavicular fossa irradiation significantly reduce the risk of recurrence in the corresponding area. However, axillary and internal mammary nodal irradiation has no impact on the risk of recurrence in the corresponding area.
Guo Xinyuan,Zhang Yujing,Zhang Na et al. Local recurrence pattern of pT1-2N1 breast cancer after modified radical mastectomy —a pooled-analysis of 5442 patients from 12 centers[J]. Chinese Journal of Radiation Oncology, 2022, 31(3): 248-252.
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