Patterns and risk factors for locoregional failures after mastectomy for breast cancer: an International Breast Cancer Study Group report
Identifieur interne : 004039 ( Main/Exploration ); précédent : 004038; suivant : 004040Patterns and risk factors for locoregional failures after mastectomy for breast cancer: an International Breast Cancer Study Group report
Auteurs : P. Karlsson [Suède] ; B. F. Cole [États-Unis] ; B. H. Chua [Australie] ; K. N. Price [États-Unis] ; J. Lindtner [Slovénie] ; J. P. Collins [Australie] ; A. Kovács [Suède] ; B. Thürlimann [Suisse] ; D. Crivellari [Italie] ; M. Castiglione-Gertsch [Suisse] ; J. F. Forbes [Australie] ; R. D. Gelber [États-Unis] ; A. Goldhirsch [Italie] ; G. Gruber [Suisse]Source :
- Annals of Oncology [ 0923-7534 ] ; 2012.
Abstract
Rates and risk factors of local, axillary and supraclavicular recurrences can guide patient selection and target for postmastectomy radiotherapy (PMRT).
Local, axillary and supraclavicular recurrences were evaluated in 8106 patients enrolled in 13 randomized trials. Patients received chemotherapy and/or endocrine therapy and mastectomy without radiotherapy. Median follow-up was 15.2 years.
Ten-year cumulative incidence for chest wall recurrence of >15% was seen in patients aged <40 years (16.1%), with ≥4 positive nodes (16.5%) or 0–7 uninvolved nodes (15.1%); for supraclavicular failures >10%: ≥4 positive nodes (10.2%); for axillary failures of >5%: aged <40 years (5.1%), unknown primary tumor size (5.2%), 0–7 uninvolved nodes (5.2%). In patients with 1–3 positive nodes, 10-year cumulative incidence for chest wall recurrence of >15% were age <40, peritumoral vessel invasion or 0–7 uninvolved nodes. Age, number of positive nodes and number of uninvolved nodes were significant parameters for each locoregional relapse site.
PMRT to the chest wall and supraclavicular fossa is supported in patients with ≥4 positive nodes. With 1–3 positive nodes, chest wall PMRT may be considered in patients aged <40 years, with 0–7 uninvolved nodes or with vascular invasion. The findings do not support PMRT to the dissected axilla.
Url:
DOI: 10.1093/annonc/mds118
PubMed: 22776708
PubMed Central: 3477880
Affiliations:
- Australie, Italie, Slovénie, Suisse, Suède, États-Unis
- Canton de Berne, Canton de Zurich, Lombardie, Massachusetts
- Berne, Boston, Milan, Zurich
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Karlsson</name><affiliation wicri:level="1"><nlm:aff id="mds118_aff1"><addr-line>Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden</addr-line></nlm:aff><country xml:lang="fr">Suède</country><wicri:regionArea>Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University Hospital, Gothenburg</wicri:regionArea><wicri:noRegion>Gothenburg</wicri:noRegion></affiliation></author><author><name sortKey="Cole, B F" sort="Cole, B F" uniqKey="Cole B" first="B. F." last="Cole">B. F. Cole</name><affiliation><nlm:aff id="mds118_aff2"><addr-line>Department of Mathematics and Statistics College of Engineering and Mathematical Sciences, University of Vermont, Burlington</addr-line></nlm:aff><wicri:noCountry code="subfield">Burlington</wicri:noCountry></affiliation><affiliation wicri:level="3"><nlm:aff id="mds118_aff3"><addr-line>IBCSG Statistical Center, Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston, USA</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>IBCSG Statistical Center, Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston</wicri:regionArea><placeName><settlement type="city">Boston</settlement><region type="state">Massachusetts</region></placeName></affiliation></author><author><name sortKey="Chua, B H" sort="Chua, B H" uniqKey="Chua B" first="B. H." last="Chua">B. H. Chua</name><affiliation wicri:level="1"><nlm:aff id="mds118_aff4"><addr-line>Department of Radiation Oncology, Peter MacCallum Cancer Centre and University of Melbourne, Melbourne, Australia</addr-line></nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea>Department of Radiation Oncology, Peter MacCallum Cancer Centre and University of Melbourne, Melbourne</wicri:regionArea><wicri:noRegion>Melbourne</wicri:noRegion></affiliation></author><author><name sortKey="Price, K N" sort="Price, K N" uniqKey="Price K" first="K. N." last="Price">K. N. Price</name><affiliation wicri:level="3"><nlm:aff id="mds118_aff3"><addr-line>IBCSG Statistical Center, Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston, USA</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>IBCSG Statistical Center, Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston</wicri:regionArea><placeName><settlement type="city">Boston</settlement><region type="state">Massachusetts</region></placeName></affiliation><affiliation wicri:level="3"><nlm:aff id="mds118_aff5"><addr-line>Frontier Science and Technology Research Foundation, Boston, USA</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Frontier Science and Technology Research Foundation, Boston</wicri:regionArea><placeName><settlement type="city">Boston</settlement><region type="state">Massachusetts</region></placeName></affiliation></author><author><name sortKey="Lindtner, J" sort="Lindtner, J" uniqKey="Lindtner J" first="J." last="Lindtner">J. Lindtner</name><affiliation wicri:level="1"><nlm:aff id="mds118_aff6"><addr-line>The Institute of Oncology, Ljubljana, Slovenia</addr-line></nlm:aff><country xml:lang="fr">Slovénie</country><wicri:regionArea>The Institute of Oncology, Ljubljana</wicri:regionArea><wicri:noRegion>Ljubljana</wicri:noRegion></affiliation></author><author><name sortKey="Collins, J P" sort="Collins, J P" uniqKey="Collins J" first="J. P." last="Collins">J. P. Collins</name><affiliation wicri:level="1"><nlm:aff id="mds118_aff7"><addr-line>Department of Surgery, Royal Melbourne Hospital, Victoria, Australia</addr-line></nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea>Department of Surgery, Royal Melbourne Hospital, Victoria</wicri:regionArea><wicri:noRegion>Victoria</wicri:noRegion></affiliation></author><author><name sortKey="Kovacs, A" sort="Kovacs, A" uniqKey="Kovacs A" first="A." last="Kovács">A. Kovács</name><affiliation wicri:level="1"><nlm:aff id="mds118_aff8"><addr-line>Department of Pathology, Sahlgrenska University Hospital, Gothenburg, Sweden</addr-line></nlm:aff><country xml:lang="fr">Suède</country><wicri:regionArea>Department of Pathology, Sahlgrenska University Hospital, Gothenburg</wicri:regionArea><wicri:noRegion>Gothenburg</wicri:noRegion></affiliation></author><author><name sortKey="Thurlimann, B" sort="Thurlimann, B" uniqKey="Thurlimann B" first="B." last="Thürlimann">B. Thürlimann</name><affiliation wicri:level="3"><nlm:aff id="mds118_aff9"><addr-line>The Breast Center, Kantonsspital, St Gallen, Switzerland and Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland</addr-line></nlm:aff><country xml:lang="fr">Suisse</country><wicri:regionArea>The Breast Center, Kantonsspital, St Gallen, Switzerland and Swiss Group for Clinical Cancer Research (SAKK), Bern</wicri:regionArea><placeName><settlement type="city">Berne</settlement><region type="région" nuts="3">Canton de Berne</region></placeName></affiliation></author><author><name sortKey="Crivellari, D" sort="Crivellari, D" uniqKey="Crivellari D" first="D." last="Crivellari">D. Crivellari</name><affiliation wicri:level="1"><nlm:aff id="mds118_aff10"><addr-line>Department of Medical Oncology, Centro di Riferimento Oncologico, Aviano, Italy</addr-line></nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Medical Oncology, Centro di Riferimento Oncologico, Aviano</wicri:regionArea><wicri:noRegion>Aviano</wicri:noRegion></affiliation></author><author><name sortKey="Castiglione Gertsch, M" sort="Castiglione Gertsch, M" uniqKey="Castiglione Gertsch M" first="M." last="Castiglione-Gertsch">M. Castiglione-Gertsch</name><affiliation wicri:level="1"><nlm:aff id="mds118_aff11"><addr-line>Gyneco-Oncology Unit, University Hospital, Geneva, Switzerland</addr-line></nlm:aff><country xml:lang="fr">Suisse</country><wicri:regionArea>Gyneco-Oncology Unit, University Hospital, Geneva</wicri:regionArea><wicri:noRegion>Geneva</wicri:noRegion></affiliation></author><author><name sortKey="Forbes, J F" sort="Forbes, J F" uniqKey="Forbes J" first="J. F." last="Forbes">J. F. Forbes</name><affiliation wicri:level="1"><nlm:aff id="mds118_aff12"><addr-line>Australian New Zealand Breast Cancer Trials Group, University of Newcastle, Calvary Mater Newcastle, Newcastle, Australia</addr-line></nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea>Australian New Zealand Breast Cancer Trials Group, University of Newcastle, Calvary Mater Newcastle, Newcastle</wicri:regionArea><wicri:noRegion>Newcastle</wicri:noRegion></affiliation></author><author><name sortKey="Gelber, R D" sort="Gelber, R D" uniqKey="Gelber R" first="R. D." last="Gelber">R. D. Gelber</name><affiliation wicri:level="3"><nlm:aff id="mds118_aff3"><addr-line>IBCSG Statistical Center, Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston, USA</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>IBCSG Statistical Center, Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston</wicri:regionArea><placeName><settlement type="city">Boston</settlement><region type="state">Massachusetts</region></placeName></affiliation><affiliation wicri:level="3"><nlm:aff id="mds118_aff5"><addr-line>Frontier Science and Technology Research Foundation, Boston, USA</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Frontier Science and Technology Research Foundation, Boston</wicri:regionArea><placeName><settlement type="city">Boston</settlement><region type="state">Massachusetts</region></placeName></affiliation><affiliation wicri:level="3"><nlm:aff id="mds118_aff13"><addr-line>Harvard School of Public Health and Harvard Medical School, Boston, USA</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Harvard School of Public Health and Harvard Medical School, Boston</wicri:regionArea><placeName><settlement type="city">Boston</settlement><region type="state">Massachusetts</region></placeName></affiliation></author><author><name sortKey="Goldhirsch, A" sort="Goldhirsch, A" uniqKey="Goldhirsch A" first="A." last="Goldhirsch">A. Goldhirsch</name><affiliation wicri:level="3"><nlm:aff id="mds118_aff14"><addr-line>European Institute of Oncology, Milan, Italy</addr-line></nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>European Institute of Oncology, Milan</wicri:regionArea><placeName><settlement type="city">Milan</settlement><region nuts="2">Lombardie</region></placeName></affiliation><affiliation><nlm:aff id="mds118_aff15"><addr-line>Swiss Center for Breast Health, Sant’Anna Clinics, Lugano-Sorengo</addr-line></nlm:aff><wicri:noCountry code="subfield">Lugano-Sorengo</wicri:noCountry></affiliation></author><author><name sortKey="Gruber, G" sort="Gruber, G" uniqKey="Gruber G" first="G." last="Gruber">G. Gruber</name><affiliation wicri:level="3"><nlm:aff id="mds118_aff16"><addr-line>Institut fuer Radiotherapie, Klinik Hirslanden, Zürich, Switzerland</addr-line></nlm:aff><country xml:lang="fr">Suisse</country><wicri:regionArea>Institut fuer Radiotherapie, Klinik Hirslanden, Zürich</wicri:regionArea><placeName><settlement type="city">Zurich</settlement><region nuts="3" type="region">Canton de Zurich</region></placeName></affiliation></author></analytic><series><title level="j">Annals of Oncology</title><idno type="ISSN">0923-7534</idno><idno type="eISSN">1569-8041</idno><imprint><date when="2012">2012</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>Rates and risk factors of local, axillary and supraclavicular recurrences can guide patient selection and target for postmastectomy radiotherapy (PMRT).</p></sec><sec><title>Patients and methods</title><p>Local, axillary and supraclavicular recurrences were evaluated in 8106 patients enrolled in 13 randomized trials. Patients received chemotherapy and/or endocrine therapy and mastectomy without radiotherapy. Median follow-up was 15.2 years.</p></sec><sec><title>Results</title><p>Ten-year cumulative incidence for chest wall recurrence of >15% was seen in patients aged <40 years (16.1%), with ≥4 positive nodes (16.5%) or 0–7 uninvolved nodes (15.1%); for supraclavicular failures >10%: ≥4 positive nodes (10.2%); for axillary failures of >5%: aged <40 years (5.1%), unknown primary tumor size (5.2%), 0–7 uninvolved nodes (5.2%). In patients with 1–3 positive nodes, 10-year cumulative incidence for chest wall recurrence of >15% were age <40, peritumoral vessel invasion or 0–7 uninvolved nodes. Age, number of positive nodes and number of uninvolved nodes were significant parameters for each locoregional relapse site.</p></sec><sec><title>Conclusion</title><p>PMRT to the chest wall and supraclavicular fossa is supported in patients with ≥4 positive nodes. With 1–3 positive nodes, chest wall PMRT may be considered in patients aged <40 years, with 0–7 uninvolved nodes or with vascular invasion. The findings do not support PMRT to the dissected axilla.</p></sec></div></front></TEI><affiliations><list><country><li>Australie</li><li>Italie</li><li>Slovénie</li><li>Suisse</li><li>Suède</li><li>États-Unis</li></country><region><li>Canton de Berne</li><li>Canton de Zurich</li><li>Lombardie</li><li>Massachusetts</li></region><settlement><li>Berne</li><li>Boston</li><li>Milan</li><li>Zurich</li></settlement></list><tree><country name="Suède"><noRegion><name sortKey="Karlsson, P" sort="Karlsson, P" uniqKey="Karlsson P" first="P." last="Karlsson">P. Karlsson</name></noRegion><name sortKey="Kovacs, A" sort="Kovacs, A" uniqKey="Kovacs A" first="A." last="Kovács">A. Kovács</name></country><country name="États-Unis"><region name="Massachusetts"><name sortKey="Cole, B F" sort="Cole, B F" uniqKey="Cole B" first="B. F." last="Cole">B. F. Cole</name></region><name sortKey="Gelber, R D" sort="Gelber, R D" uniqKey="Gelber R" first="R. D." last="Gelber">R. D. Gelber</name><name sortKey="Gelber, R D" sort="Gelber, R D" uniqKey="Gelber R" first="R. D." last="Gelber">R. D. Gelber</name><name sortKey="Gelber, R D" sort="Gelber, R D" uniqKey="Gelber R" first="R. D." last="Gelber">R. D. Gelber</name><name sortKey="Price, K N" sort="Price, K N" uniqKey="Price K" first="K. N." last="Price">K. N. Price</name><name sortKey="Price, K N" sort="Price, K N" uniqKey="Price K" first="K. N." last="Price">K. N. Price</name></country><country name="Australie"><noRegion><name sortKey="Chua, B H" sort="Chua, B H" uniqKey="Chua B" first="B. H." last="Chua">B. H. Chua</name></noRegion><name sortKey="Collins, J P" sort="Collins, J P" uniqKey="Collins J" first="J. P." last="Collins">J. P. Collins</name><name sortKey="Forbes, J F" sort="Forbes, J F" uniqKey="Forbes J" first="J. F." last="Forbes">J. F. Forbes</name></country><country name="Slovénie"><noRegion><name sortKey="Lindtner, J" sort="Lindtner, J" uniqKey="Lindtner J" first="J." last="Lindtner">J. Lindtner</name></noRegion></country><country name="Suisse"><region name="Canton de Berne"><name sortKey="Thurlimann, B" sort="Thurlimann, B" uniqKey="Thurlimann B" first="B." last="Thürlimann">B. Thürlimann</name></region><name sortKey="Castiglione Gertsch, M" sort="Castiglione Gertsch, M" uniqKey="Castiglione Gertsch M" first="M." last="Castiglione-Gertsch">M. Castiglione-Gertsch</name><name sortKey="Gruber, G" sort="Gruber, G" uniqKey="Gruber G" first="G." last="Gruber">G. Gruber</name></country><country name="Italie"><noRegion><name sortKey="Crivellari, D" sort="Crivellari, D" uniqKey="Crivellari D" first="D." last="Crivellari">D. Crivellari</name></noRegion><name sortKey="Goldhirsch, A" sort="Goldhirsch, A" uniqKey="Goldhirsch A" first="A." last="Goldhirsch">A. Goldhirsch</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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