Comparison of Breast Conserving Surgery Followed by Radiation Therapy with Mastectomy Alone for Pathologic N1 Breast Cancer Patients in the Era of Anthracycline Plus Taxane-Based Chemotherapy: A Multicenter Retrospective Study (KROG 1418)
- Author:
Gyu Sang YOO
1
;
Won PARK
;
Jeong Il YU
;
Doo Ho CHOI
;
Yeon Joo KIM
;
Kyung Hwan SHIN
;
Chan Woo WEE
;
Kyubo KIM
;
Kyung Ran PARK
;
Yong Bae KIM
;
Sung Ja AHN
;
Jong Hoon LEE
;
Jin Hee KIM
;
Mison CHUN
;
Hyung Sik LEE
;
Jung Soo KIM
;
Jihye CHA
Author Information
- Publication Type:Multicenter Study
- Keywords: Breast neoplasms; Pathologic N1; Breast conserving surgery; Radiation Radiotherapy; Mastectomy; Anthracyclines; Taxane; Survival
- MeSH: Anthracyclines; Breast Neoplasms; Breast; Cohort Studies; Disease-Free Survival; Drug Therapy; Follow-Up Studies; Humans; Lymphedema; Mastectomy; Mastectomy, Modified Radical; Mastectomy, Segmental; Medical Records; Propensity Score; Radiation Pneumonitis; Retrospective Studies
- From:Cancer Research and Treatment 2019;51(3):1041-1051
- CountryRepublic of Korea
- Language:English
- Abstract: PURPOSE: We compared the oncologic outcomes of breast-conserving surgery plus radiation therapy (BCS+RT) and modified radical mastectomy (MRM) under anthracycline plus taxane-based (AT) regimens and investigated the role of adjuvant radiation therapy (RT) in patients with pathologic N1 (pN1) breast cancer treated by mastectomy. MATERIALS AND METHODS: We retrospectively reviewed the medical records of 2,011 patients with pN1 breast cancer who underwent BCS+RT or MRM alone at 12 institutions between January 2006 and December 2010. Two-to-one propensity score matching was performed for balances in variables between the groups. RESULTS: The median follow-up duration for the total cohort was 69 months (range, 1 to 114 months). After propensity score matching, 1,074 patients (676 in the BCS+RT group and 398 in the MRM-alone group) were analyzed finally. The overall survival, disease-free survival, locoregional failure-free survival, and regional failure-free survival (RFFS) curves of the BCS+RT group vs. MRM-alone group were not significantly different. The subgroup analysis revealed that in the group with both lymphovascular invasion (LVI) and histologic grade (HG) III, the BCS+RT showed significantly superior RFFS (p=0.008). Lymphedema (p=0.007) and radiation pneumonitis (p=0.031) occurred more frequently in the BCS+RT group than in the MRM-alone group, significantly. CONCLUSION: There are no differences in oncologic outcomes between BCS+RT and MRM-alone groups under the AT chemotherapy regimens for pN1 breast cancer. However, BCS+RT group showed superior RFFS to MRM-alone group in the patients with LVI and HG III. Adjuvant RT might be considerable for pN1 breast cancer patients with LVI and HG III.
