Regional recurrence in breast cancer patients with one to three positive axillary lymph nodes treated with breast-conserving surgery and whole breast irradiation
Identifieur interne : 000228 ( Main/Exploration ); précédent : 000227; suivant : 000229Regional recurrence in breast cancer patients with one to three positive axillary lymph nodes treated with breast-conserving surgery and whole breast irradiation
Auteurs : Kimiko Hirata [Japon] ; Michio Yoshimura [Japon] ; Minoru Inoue [Japon] ; Chikako Yamauchi [Japon] ; Masakazu Ogura [Japon] ; Masakazu Toi ; Eiji Suzuki ; Megumi Takeuchi ; Masahiro Takada ; Masahiro Hiraoka [Japon]Source :
- Journal of Radiation Research [ 0449-3060 ] ; 2017.
Abstract
Radiotherapy with breast-conserving therapy plays a crucial role in the treatment of early breast cancer. However, optimal radiotherapy targets have been controversial. We therefore evaluated regional recurrence in breast cancer patients with one to three positive lymph nodes (LNs) treated with breast-conserving surgery (BCS) followed by whole-breast irradiation (WBI). From 1993 to 2010, 121 breast cancer patients with one to three positive LNs who underwent BCS followed by WBI were analyzed. All patients underwent radiotherapy with two tangential fields to the whole breast. To evaluate the radiation dose to the axillary LNs, we contoured axillary LNs area and evaluated the dose–volumetric parameters. The median follow-up time was 112.4 months (range, 15.6–248.1 months). The 5-year overall survival and disease-free survival rates were 95.6% and 86.6%, respectively. The 5-year regional recurrence–free rate (RRFR) was 97.4%. During follow-up, six patients had regional recurrence. The pathological T stage was the factor best associated with the 5-year RRFR using the log-rank test, with 100.0% in the pT1 cohort versus 94.7% in the pT2–4 cohort (
Url:
DOI: 10.1093/jrr/rrw071
PubMed: 27422931
PubMed Central: 5321183
Affiliations:
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last="Takeuchi">Megumi Takeuchi</name><affiliation><nlm:aff id="rrw071af2"><addr-line>Department of Breast Surgery</addr-line>,<institution>Kyoto University Hospital, 54 Shogoin-Kawaracho, Sakyo-ku, Kyoto 606-8507, Japan</institution></nlm:aff></affiliation></author><author><name sortKey="Takada, Masahiro" sort="Takada, Masahiro" uniqKey="Takada M" first="Masahiro" last="Takada">Masahiro Takada</name><affiliation><nlm:aff id="rrw071af2"><addr-line>Department of Breast Surgery</addr-line>,<institution>Kyoto University Hospital, 54 Shogoin-Kawaracho, Sakyo-ku, Kyoto 606-8507, Japan</institution></nlm:aff></affiliation></author><author><name sortKey="Hiraoka, Masahiro" sort="Hiraoka, Masahiro" uniqKey="Hiraoka M" first="Masahiro" last="Hiraoka">Masahiro Hiraoka</name><affiliation wicri:level="1"><nlm:aff id="rrw071af1"><addr-line>Department of Radiation Oncology and Image-applied Therapy, Graduate School of Medicine</addr-line>,<institution>Kyoto University</institution>,<addr-line>54 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606-8507</addr-line>,<country>Japan</country></nlm:aff><country xml:lang="fr">Japon</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Yoshimura, Michio" sort="Yoshimura, Michio" uniqKey="Yoshimura M" first="Michio" last="Yoshimura">Michio Yoshimura</name><affiliation wicri:level="1"><nlm:aff id="rrw071af1"><addr-line>Department of Radiation Oncology and Image-applied Therapy, Graduate School of Medicine</addr-line>,<institution>Kyoto University</institution>,<addr-line>54 Shogoin-Kawaharacho, Sakyo-ku, Kyoto 606-8507</addr-line>,<country>Japan</country></nlm:aff><country xml:lang="fr">Japon</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Inoue, Minoru" sort="Inoue, Minoru" uniqKey="Inoue M" first="Minoru" last="Inoue">Minoru Inoue</name><affiliation wicri:level="1"><nlm:aff id="rrw071af1"><addr-line>Department of Radiation Oncology and Image-applied Therapy, Graduate School of Medicine</addr-line>,<institution>Kyoto University</institution>,<addr-line>54 Shogoin-Kawaharacho, Sakyo-ku, Kyoto 606-8507</addr-line>,<country>Japan</country></nlm:aff><country xml:lang="fr">Japon</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Yamauchi, Chikako" sort="Yamauchi, Chikako" uniqKey="Yamauchi C" first="Chikako" last="Yamauchi">Chikako Yamauchi</name><affiliation wicri:level="1"><nlm:aff id="rrw071af1"><addr-line>Department of Radiation Oncology and Image-applied Therapy, Graduate School of Medicine</addr-line>,<institution>Kyoto University</institution>,<addr-line>54 Shogoin-Kawaharacho, Sakyo-ku, Kyoto 606-8507</addr-line>,<country>Japan</country></nlm:aff><country xml:lang="fr">Japon</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Ogura, Masakazu" sort="Ogura, Masakazu" uniqKey="Ogura M" first="Masakazu" last="Ogura">Masakazu Ogura</name><affiliation wicri:level="1"><nlm:aff id="rrw071af1"><addr-line>Department of Radiation Oncology and Image-applied Therapy, Graduate School of Medicine</addr-line>,<institution>Kyoto University</institution>,<addr-line>54 Shogoin-Kawaharacho, Sakyo-ku, Kyoto 606-8507</addr-line>,<country>Japan</country></nlm:aff><country xml:lang="fr">Japon</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Toi, Masakazu" sort="Toi, Masakazu" uniqKey="Toi M" first="Masakazu" last="Toi">Masakazu Toi</name><affiliation><nlm:aff id="rrw071af2"><addr-line>Department of Breast Surgery</addr-line>,<institution>Kyoto University Hospital, 54 Shogoin-Kawaracho, Sakyo-ku, Kyoto 606-8507, Japan</institution></nlm:aff></affiliation></author><author><name sortKey="Suzuki, Eiji" sort="Suzuki, Eiji" uniqKey="Suzuki E" first="Eiji" last="Suzuki">Eiji Suzuki</name><affiliation><nlm:aff id="rrw071af2"><addr-line>Department of Breast Surgery</addr-line>,<institution>Kyoto University Hospital, 54 Shogoin-Kawaracho, Sakyo-ku, Kyoto 606-8507, Japan</institution></nlm:aff></affiliation></author><author><name sortKey="Takeuchi, Megumi" sort="Takeuchi, Megumi" uniqKey="Takeuchi M" first="Megumi" last="Takeuchi">Megumi Takeuchi</name><affiliation><nlm:aff id="rrw071af2"><addr-line>Department of Breast Surgery</addr-line>,<institution>Kyoto University Hospital, 54 Shogoin-Kawaracho, Sakyo-ku, Kyoto 606-8507, Japan</institution></nlm:aff></affiliation></author><author><name sortKey="Takada, Masahiro" sort="Takada, Masahiro" uniqKey="Takada M" first="Masahiro" last="Takada">Masahiro Takada</name><affiliation><nlm:aff id="rrw071af2"><addr-line>Department of Breast Surgery</addr-line>,<institution>Kyoto University Hospital, 54 Shogoin-Kawaracho, Sakyo-ku, Kyoto 606-8507, Japan</institution></nlm:aff></affiliation></author><author><name sortKey="Hiraoka, Masahiro" sort="Hiraoka, Masahiro" uniqKey="Hiraoka M" first="Masahiro" last="Hiraoka">Masahiro Hiraoka</name><affiliation wicri:level="1"><nlm:aff id="rrw071af1"><addr-line>Department of Radiation Oncology and Image-applied Therapy, Graduate School of Medicine</addr-line>,<institution>Kyoto University</institution>,<addr-line>54 Shogoin-Kawaharacho, Sakyo-ku, Kyoto 606-8507</addr-line>,<country>Japan</country></nlm:aff><country xml:lang="fr">Japon</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author></analytic><series><title level="j">Journal of Radiation Research</title><idno type="ISSN">0449-3060</idno><idno type="eISSN">1349-9157</idno><imprint><date when="2017">2017</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>Radiotherapy with breast-conserving therapy plays a crucial role in the treatment of early breast cancer. However, optimal radiotherapy targets have been controversial. We therefore evaluated regional recurrence in breast cancer patients with one to three positive lymph nodes (LNs) treated with breast-conserving surgery (BCS) followed by whole-breast irradiation (WBI). From 1993 to 2010, 121 breast cancer patients with one to three positive LNs who underwent BCS followed by WBI were analyzed. All patients underwent radiotherapy with two tangential fields to the whole breast. To evaluate the radiation dose to the axillary LNs, we contoured axillary LNs area and evaluated the dose–volumetric parameters. The median follow-up time was 112.4 months (range, 15.6–248.1 months). The 5-year overall survival and disease-free survival rates were 95.6% and 86.6%, respectively. The 5-year regional recurrence–free rate (RRFR) was 97.4%. During follow-up, six patients had regional recurrence. The pathological T stage was the factor best associated with the 5-year RRFR using the log-rank test, with 100.0% in the pT1 cohort versus 94.7% in the pT2–4 cohort (<italic>P</italic> < 0.01). The radiation dose to the axillary LNs did not contribute to the RRFR. In conclusion, while the pathological T stage was the prognostic factor best associated with regional recurrence, few regional recurrences were observed in early breast cancer patients with one to three LNs treated with BCS followed by WBI. Unintentional radiation doses to the axillary LNs using standard WBI were not related to the RRFR after axillary dissection.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Fisher, B" uniqKey="Fisher B">B Fisher</name></author><author><name sortKey="Bryant, J" uniqKey="Bryant J">J Bryant</name></author><author><name sortKey="Dignam, Jj" uniqKey="Dignam J">JJ Dignam</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Vicini, Fa" uniqKey="Vicini F">FA Vicini</name></author><author><name sortKey="Horwitz, Em" uniqKey="Horwitz E">EM Horwitz</name></author><author><name sortKey="Lacerna, Md" uniqKey="Lacerna M">MD Lacerna</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Grills, Is" uniqKey="Grills I">IS Grills</name></author><author><name sortKey="Kestin, Ll" uniqKey="Kestin L">LL Kestin</name></author><author><name sortKey="Goldstein, N" uniqKey="Goldstein N">N Goldstein</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Whelan, Tj" uniqKey="Whelan T">TJ Whelan</name></author><author><name sortKey="Olivotto, Ia" uniqKey="Olivotto I">IA Olivotto</name></author><author><name sortKey="Parulekar, Wr" uniqKey="Parulekar W">WR Parulekar</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Poortmans, Pm" uniqKey="Poortmans P">PM Poortmans</name></author><author><name sortKey="Collette, S" uniqKey="Collette S">S Collette</name></author><author><name sortKey="Kirkove, C" uniqKey="Kirkove C">C Kirkove</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Fortin, A" uniqKey="Fortin A">A Fortin</name></author><author><name sortKey="Dagnault, A" uniqKey="Dagnault A">A Dagnault</name></author><author><name sortKey="Blondeau, L" uniqKey="Blondeau L">L Blondeau</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Powell, Sn" uniqKey="Powell S">SN Powell</name></author><author><name sortKey="Taghian, Ag" uniqKey="Taghian A">AG Taghian</name></author><author><name sortKey="Kachnic, La" uniqKey="Kachnic L">LA Kachnic</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Reed, Dr" uniqKey="Reed D">DR Reed</name></author><author><name sortKey="Lindsley, Sk" uniqKey="Lindsley S">SK Lindsley</name></author><author><name sortKey="Mann, Gn" uniqKey="Mann G">GN Mann</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Reznik, J" uniqKey="Reznik J">J Reznik</name></author><author><name sortKey="Cicchetti, Mg" uniqKey="Cicchetti M">MG Cicchetti</name></author><author><name sortKey="Degaspe, B" uniqKey="Degaspe B">B Degaspe</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Offersen, Bv" uniqKey="Offersen B">BV Offersen</name></author><author><name sortKey="Boersma, Lj" uniqKey="Boersma L">LJ Boersma</name></author><author><name sortKey="Kirkove, C" uniqKey="Kirkove C">C Kirkove</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Truong, Pt" uniqKey="Truong P">PT Truong</name></author><author><name sortKey="Jones, So" uniqKey="Jones S">SO Jones</name></author><author><name sortKey="Kader, Ha" uniqKey="Kader H">HA Kader</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Bedi, C" uniqKey="Bedi C">C Bedi</name></author><author><name sortKey="Kron, T" uniqKey="Kron T">T Kron</name></author><author><name sortKey="Willis, D" uniqKey="Willis D">D Willis</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kahan, Z" uniqKey="Kahan Z">Z Kahan</name></author><author><name sortKey="Csenki, M" uniqKey="Csenki M">M Csenki</name></author><author><name sortKey="Varga, Z" uniqKey="Varga Z">Z Varga</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Viani, Ga" uniqKey="Viani G">GA Viani</name></author><author><name sortKey="Godoi Da Silva, Lb" uniqKey="Godoi Da Silva L">LB Godoi da Silva</name></author><author><name sortKey="Viana, Bs" uniqKey="Viana B">BS. Viana</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Sharma, R" uniqKey="Sharma R">R Sharma</name></author><author><name sortKey="Spierer, M" uniqKey="Spierer M">M Spierer</name></author><author><name sortKey="Mutyala, S" uniqKey="Mutyala S">S Mutyala</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Giuliano, Ae" uniqKey="Giuliano A">AE Giuliano</name></author><author><name sortKey="Hunt, Kk" uniqKey="Hunt K">KK Hunt</name></author><author><name sortKey="Ballman, Kv" uniqKey="Ballman K">KV Ballman</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Giuliano, Ae" uniqKey="Giuliano A">AE Giuliano</name></author><author><name sortKey="Mccall, L" uniqKey="Mccall L">L McCall</name></author><author><name sortKey="Beitsch, P" uniqKey="Beitsch P">P Beitsch</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Truong, Pt" uniqKey="Truong P">PT Truong</name></author><author><name sortKey="Berthelet, E" uniqKey="Berthelet E">E Berthelet</name></author><author><name sortKey="Lee, J" uniqKey="Lee J">J Lee</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Japon</li></country></list><tree><noCountry><name sortKey="Suzuki, Eiji" sort="Suzuki, Eiji" uniqKey="Suzuki E" first="Eiji" last="Suzuki">Eiji Suzuki</name><name sortKey="Takada, Masahiro" sort="Takada, Masahiro" uniqKey="Takada M" first="Masahiro" last="Takada">Masahiro Takada</name><name sortKey="Takeuchi, Megumi" sort="Takeuchi, Megumi" uniqKey="Takeuchi M" first="Megumi" last="Takeuchi">Megumi Takeuchi</name><name sortKey="Toi, Masakazu" sort="Toi, Masakazu" uniqKey="Toi M" first="Masakazu" last="Toi">Masakazu Toi</name></noCountry><country name="Japon"><noRegion><name sortKey="Hirata, Kimiko" sort="Hirata, Kimiko" uniqKey="Hirata K" first="Kimiko" last="Hirata">Kimiko Hirata</name></noRegion><name sortKey="Hiraoka, Masahiro" sort="Hiraoka, Masahiro" uniqKey="Hiraoka M" first="Masahiro" last="Hiraoka">Masahiro Hiraoka</name><name sortKey="Inoue, Minoru" sort="Inoue, Minoru" uniqKey="Inoue M" first="Minoru" last="Inoue">Minoru Inoue</name><name sortKey="Ogura, Masakazu" sort="Ogura, Masakazu" uniqKey="Ogura M" first="Masakazu" last="Ogura">Masakazu Ogura</name><name sortKey="Yamauchi, Chikako" sort="Yamauchi, Chikako" uniqKey="Yamauchi C" first="Chikako" last="Yamauchi">Chikako Yamauchi</name><name sortKey="Yoshimura, Michio" sort="Yoshimura, Michio" uniqKey="Yoshimura M" first="Michio" last="Yoshimura">Michio Yoshimura</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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