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Locoregional recurrence patterns in women with breast cancer who have not undergone post-mastectomy radiotherapy.

ABSTRACT: BACKGROUND:To analyze the patterns of locoregional recurrence in breast cancer patients after mastectomy. METHODS:The retrospective study included 7073 women with breast cancer without post-mastectomy radiotherapy: 4604 (65.1%) had pT1-2?N0 disease (low risk); 2042 (28.9%), pT1-2?N1 (intermediate risk); and 427 (6.0%), pT3-4 and/or pN2-3, or pT1-2?N1 after neoadjuvant chemotherapy (high risk). The distribution of cumulative locoregional recurrence was analyzed. The local recurrence and regional recurrence rates were estimated by the Kaplan-Meier method, and differences were compared with the log-rank test. Multivariate analysis was performed using Cox logistic regression analysis. RESULTS:In the median follow-up of 63.0?months, 469 patients had locoregional recurrence: chest wall recurrence in 238 (50.7%) cases, supraclavicular/infraclavicular nodes in 236 (50.3%) cases, axilla in 92 (19.6%), and internal mammary nodes in 50 (10.7%) cases. The 5-year local recurrence and regional recurrence rates were 2.5 and 4.4%, respectively. Subgroup analysis of the three risk groups and five molecular subtypes (luminal A, luminal B-Her2 negative, luminal B-Her2 positive, Her2-enriched, and triple negative) also showed that the chest wall and supraclavicular/infraclavicular nodes were the most common recurrence sites. Age, tumor location, T stage, N stage, and hormone receptor status were independent prognostic factors for both local recurrence and regional recurrence (p?

SUBMITTER: Zhao X

PROVIDER: S-EPMC7487762 | biostudies-literature | 2020 Sep

REPOSITORIES: biostudies-literature

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Locoregional recurrence patterns in women with breast cancer who have not undergone post-mastectomy radiotherapy.

Zhao Xuran X Tang Yu Y Wang Shulian S Yang Yong Y Fang Hui H Wang Jianyang J Jing Hao H Zhang Jianghu J Sun Guangyi G Chen Siye S Jin Jing J Song Yongwen Y Liu Yueping Y Chen Bo B Qi Shunan S Li Ning N Tang Yuan Y Lu Ningning N Ren Hua H Li Yexiong Y

Radiation oncology (London, England) 20200904 1

<h4>Background</h4>To analyze the patterns of locoregional recurrence in breast cancer patients after mastectomy.<h4>Methods</h4>The retrospective study included 7073 women with breast cancer without post-mastectomy radiotherapy: 4604 (65.1%) had pT1-2 N0 disease (low risk); 2042 (28.9%), pT1-2 N1 (intermediate risk); and 427 (6.0%), pT3-4 and/or pN2-3, or pT1-2 N1 after neoadjuvant chemotherapy (high risk). The distribution of cumulative locoregional recurrence was analyzed. The local recurrenc ...[more]

PMID: 32887640

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Project description:BackgroundWe aimed to evaluate the influence of mammographic breast density at diagnosis on the risk of cancer recurrence and survival outcomes in patients with invasive breast cancer after modified radical mastectomy.MethodsThis case-control study included 121 case-control pairs of women diagnosed with invasive breast cancer between 2004 and 2009, and who had undergone modified radical mastectomy and had mammographic breast density measured before or at diagnosis. Women with known locoregional recurrence or distant metastasis were matched by pathological disease stage, age, and year of diagnosis to women without recurrence. Locoregional recurrence was defined as recurrence in the ipsilateral chest wall, or axillary, internal mammary, or supraclavicular nodes. The median follow-up duration was 84.0 months for case patients and 92.9 months for control patients.ResultsPatients with heterogeneously dense (50-75% density) and extremely dense (>75% density) breasts had an increased risk of locoregional recurrence (hazard ratios 3.1 and 5.7, 95% confidence intervals 1.1-9.8 and 1.2-34.9, p = 0.043 and 0.048, respectively) than did women with less dense breasts. Positive margins after surgery also increased the risk of locoregional recurrence (hazard ratio 3.3, 95% confidence interval 1.3-8.3, p = 0.010). Multivariate analysis that included dense breasts (>50% density), positive margin, no adjuvant radiotherapy, and no adjuvant chemotherapy revealed that dense breasts were significant factors for predicting locoregional recurrence risk (hazard ratio 3.6, 95% confidence interval 1.2-11.1, p = 0.025).ConclusionsOur results demonstrate that dense breast tissue (>50% density) increased the risk of locoregional recurrence after modified radical mastectomy in patients with invasive breast cancer. Additional prospective studies are necessary to validate these findings.Trial registrationThe study is retrospectively registered with ClinicalTrials.gov, number NCT02771665 , on May 11, 2016.

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Locoregional recurrence patterns in women with breast cancer who have not undergone post-mastectomy radiotherapy.

Publications

Locoregional recurrence patterns in women with breast cancer who have not undergone post-mastectomy radiotherapy.

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