Patterns and risk factors for locoregional failures after mastectomy for breast cancer: an International Breast Cancer Study Group report
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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.
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DOI: 10.1093/annonc/mds118
PubMed: 22776708
PubMed Central: 3477880
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B. F. Cole<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="1"><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></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>Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Patterns and risk factors for locoregional failures after mastectomy for breast cancer: an International Breast Cancer Study Group report</title><author><name sortKey="Karlsson, P" sort="Karlsson, P" uniqKey="Karlsson P" first="P." last="Karlsson">P. 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></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="1"><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></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></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="1"><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></affiliation><affiliation wicri:level="1"><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></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></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></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></affiliation></author><author><name sortKey="Thurlimann, B" sort="Thurlimann, B" uniqKey="Thurlimann B" first="B." last="Thürlimann">B. Thürlimann</name><affiliation wicri:level="1"><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></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></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></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></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="1"><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></affiliation><affiliation wicri:level="1"><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></affiliation><affiliation wicri:level="1"><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></affiliation></author><author><name sortKey="Goldhirsch, A" sort="Goldhirsch, A" uniqKey="Goldhirsch A" first="A." last="Goldhirsch">A. Goldhirsch</name><affiliation wicri:level="1"><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></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="1"><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></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">22776708</idno><idno type="pmc">3477880</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3477880</idno><idno type="RBID">PMC:3477880</idno><idno type="doi">10.1093/annonc/mds118</idno><date when="2012">2012</date><idno type="wicri:Area/Pmc/Corpus">002C17</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">002C17</idno><idno type="wicri:Area/Pmc/Curation">002C16</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">002C16</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Patterns and risk factors for locoregional failures after mastectomy for breast cancer: an International Breast Cancer Study Group report</title><author><name sortKey="Karlsson, P" sort="Karlsson, P" uniqKey="Karlsson P" first="P." last="Karlsson">P. 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></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="1"><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></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></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="1"><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></affiliation><affiliation wicri:level="1"><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></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></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></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></affiliation></author><author><name sortKey="Thurlimann, B" sort="Thurlimann, B" uniqKey="Thurlimann B" first="B." last="Thürlimann">B. Thürlimann</name><affiliation wicri:level="1"><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></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></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></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></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="1"><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></affiliation><affiliation wicri:level="1"><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></affiliation><affiliation wicri:level="1"><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></affiliation></author><author><name sortKey="Goldhirsch, A" sort="Goldhirsch, A" uniqKey="Goldhirsch A" first="A." last="Goldhirsch">A. Goldhirsch</name><affiliation wicri:level="1"><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></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="1"><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></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><pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Ann Oncol</journal-id><journal-id journal-id-type="iso-abbrev">Ann. Oncol</journal-id><journal-id journal-id-type="hwp">annonc</journal-id><journal-id journal-id-type="publisher-id">annonc</journal-id><journal-title-group><journal-title>Annals of Oncology</journal-title></journal-title-group><issn pub-type="ppub">0923-7534</issn><issn pub-type="epub">1569-8041</issn><publisher><publisher-name>Oxford University Press</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">22776708</article-id><article-id pub-id-type="pmc">3477880</article-id><article-id pub-id-type="doi">10.1093/annonc/mds118</article-id><article-categories><subj-group subj-group-type="heading"><subject>Original Articles</subject><subj-group subj-group-type="heading"><subject>Breast Cancer</subject></subj-group></subj-group></article-categories><title-group><article-title>Patterns and risk factors for locoregional failures after mastectomy for breast cancer: an International Breast Cancer Study Group report</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Karlsson</surname><given-names>P.</given-names></name><xref ref-type="aff" rid="mds118_aff1">1</xref><xref ref-type="corresp" rid="mds118_cor1">*</xref></contrib><contrib contrib-type="author"><name><surname>Cole</surname><given-names>B. F.</given-names></name><xref ref-type="aff" rid="mds118_aff2">2</xref><xref ref-type="aff" rid="mds118_aff3">3</xref></contrib><contrib contrib-type="author"><name><surname>Chua</surname><given-names>B. H.</given-names></name><xref ref-type="aff" rid="mds118_aff4">4</xref></contrib><contrib contrib-type="author"><name><surname>Price</surname><given-names>K. N.</given-names></name><xref ref-type="aff" rid="mds118_aff3">3</xref><xref ref-type="aff" rid="mds118_aff5">5</xref></contrib><contrib contrib-type="author"><name><surname>Lindtner</surname><given-names>J.</given-names></name><xref ref-type="aff" rid="mds118_aff6">6</xref></contrib><contrib contrib-type="author"><name><surname>Collins</surname><given-names>J. P.</given-names></name><xref ref-type="aff" rid="mds118_aff7">7</xref></contrib><contrib contrib-type="author"><name><surname>Kovács</surname><given-names>A.</given-names></name><xref ref-type="aff" rid="mds118_aff8">8</xref></contrib><contrib contrib-type="author"><name><surname>Thürlimann</surname><given-names>B.</given-names></name><xref ref-type="aff" rid="mds118_aff9">9</xref></contrib><contrib contrib-type="author"><name><surname>Crivellari</surname><given-names>D.</given-names></name><xref ref-type="aff" rid="mds118_aff10">10</xref></contrib><contrib contrib-type="author"><name><surname>Castiglione-Gertsch</surname><given-names>M.</given-names></name><xref ref-type="aff" rid="mds118_aff11">11</xref></contrib><contrib contrib-type="author"><name><surname>Forbes</surname><given-names>J. F.</given-names></name><xref ref-type="aff" rid="mds118_aff12">12</xref></contrib><contrib contrib-type="author"><name><surname>Gelber</surname><given-names>R. D.</given-names></name><xref ref-type="aff" rid="mds118_aff3">3</xref><xref ref-type="aff" rid="mds118_aff5">5</xref><xref ref-type="aff" rid="mds118_aff13">13</xref></contrib><contrib contrib-type="author"><name><surname>Goldhirsch</surname><given-names>A.</given-names></name><xref ref-type="aff" rid="mds118_aff14">14</xref><xref ref-type="aff" rid="mds118_aff15">15</xref></contrib><contrib contrib-type="author"><name><surname>Gruber</surname><given-names>G.</given-names></name><xref ref-type="aff" rid="mds118_aff16">16</xref><on-behalf-of>for the International Breast Cancer Study Group</on-behalf-of></contrib></contrib-group><aff id="mds118_aff1"><label>1</label><addr-line>Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden</addr-line></aff><aff id="mds118_aff2"><label>2</label><addr-line>Department of Mathematics and Statistics College of Engineering and Mathematical Sciences, University of Vermont, Burlington</addr-line></aff><aff id="mds118_aff3"><label>3</label><addr-line>IBCSG Statistical Center, Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston, USA</addr-line></aff><aff id="mds118_aff4"><label>4</label><addr-line>Department of Radiation Oncology, Peter MacCallum Cancer Centre and University of Melbourne, Melbourne, Australia</addr-line></aff><aff id="mds118_aff5"><label>5</label><addr-line>Frontier Science and Technology Research Foundation, Boston, USA</addr-line></aff><aff id="mds118_aff6"><label>6</label><addr-line>The Institute of Oncology, Ljubljana, Slovenia</addr-line></aff><aff id="mds118_aff7"><label>7</label><addr-line>Department of Surgery, Royal Melbourne Hospital, Victoria, Australia</addr-line></aff><aff id="mds118_aff8"><label>8</label><addr-line>Department of Pathology, Sahlgrenska University Hospital, Gothenburg, Sweden</addr-line></aff><aff id="mds118_aff9"><label>9</label><addr-line>The Breast Center, Kantonsspital, St Gallen, Switzerland and Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland</addr-line></aff><aff id="mds118_aff10"><label>10</label><addr-line>Department of Medical Oncology, Centro di Riferimento Oncologico, Aviano, Italy</addr-line></aff><aff id="mds118_aff11"><label>11</label><addr-line>Gyneco-Oncology Unit, University Hospital, Geneva, Switzerland</addr-line></aff><aff id="mds118_aff12"><label>12</label><addr-line>Australian New Zealand Breast Cancer Trials Group, University of Newcastle, Calvary Mater Newcastle, Newcastle, Australia</addr-line></aff><aff id="mds118_aff13"><label>13</label><addr-line>Harvard School of Public Health and Harvard Medical School, Boston, USA</addr-line></aff><aff id="mds118_aff14"><label>14</label><addr-line>European Institute of Oncology, Milan, Italy</addr-line></aff><aff id="mds118_aff15"><label>15</label><addr-line>Swiss Center for Breast Health, Sant’Anna Clinics, Lugano-Sorengo</addr-line></aff><aff id="mds118_aff16"><label>16</label><addr-line>Institut fuer Radiotherapie, Klinik Hirslanden, Zürich, Switzerland</addr-line></aff><author-notes><corresp id="mds118_cor1"><label>*</label><italic>Correspondence to:</italic> Dr P. Karlsson, Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University Hospital, Per Dubbsgatan 14, 5th floor, Gothenburg S 413 45, Sweden. Tel: +46-31-342-7401; Fax: +46-31-820114; E-mail: <email>per.karlsson@oncology.gu.se</email></corresp></author-notes><pub-date pub-type="ppub"><month>11</month><year>2012</year></pub-date><pub-date pub-type="epub"><day>9</day><month>7</month><year>2012</year></pub-date><pub-date pub-type="pmc-release"><day>1</day><month>11</month><year>2013</year></pub-date><pmc-comment> PMC Release delay is 12 months and 0 days and was based on the
<volume>23</volume><issue>11</issue><fpage>2852</fpage><lpage>2858</lpage><history><date date-type="received"><day>4</day><month>8</month><year>2011</year></date><date date-type="rev-recd"><day>4</day><month>1</month><year>2012</year></date><date date-type="accepted"><day>20</day><month>3</month><year>2012</year></date></history><permissions><copyright-statement>© The Author 2012. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oup.com.</copyright-statement><copyright-year>2012</copyright-year></permissions><self-uri content-type="pdf" xlink:type="simple" xlink:href="mds118.pdf"></self-uri><abstract><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></abstract><kwd-group><kwd>adjuvant treatment</kwd><kwd>breast cancer</kwd><kwd>locoregional recurrence</kwd><kwd>postmastectomy radiotherapy</kwd></kwd-group><counts><page-count count="7"></page-count></counts></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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