Clinical Research Papers:
Effect of postmastectomy radiotherapy on triple-negative breast cancer with T1-2 and 1-3 positive axillary lymph nodes: a population-based study using the SEER 18 database
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Jie Zhang1,*, Xiao-Xiao Wang2,*, Jun-Yu Lian2,* and Chuan-Gui Song1
1Department of Breast Surgery, Affiliated Union Hospital, Fujian Medical University, Fuzhou, China
2Department of Gynecology and Obstetrics, Fujian Provincial Maternity and Children Health Hospital, Teaching Hospital of Fujian Medical University, Fuzhou, China
*These authors have contributed equally to this work
Chuan-Gui Song, email: [email protected]
Keywords: postmastectomy radiotherapy; triple-negative breast cancer; 1-3 positive lymph nodes; overall survival; breast cancer-specific survival
Received: October 31, 2017 Accepted: February 24, 2018 Published: August 27, 2019
There is consensus on the routine use of postmastectomy radiotherapy (PMRT) in patients with four or more positive axillary lymph nodes. However, the benefits of PMRT in patients with T1-2 and 1-3 involved lymph nodes still remain controversial. Data from the Surveillance, Epidemiology, and End Results Program (SEER) of the United States between 2010 and 2012 were used to analyze the outcomes of 675 triple-negative breast cancer (TNBC) patients with T1-2 and 1-3 lymph nodes involved. Those patients were subdivided into radiotherapy (RT) (312) and no-RT groups (363). After a median follow-up time of 37 months, Kaplan-Meier analysis showed that PMRT significantly improved overall survival (OS) but not breast cancer-specific survival (BCSS) in the total cohort of 675 patients (P=0.033 and P=0.063). And it was demonstrated that PMRT were independently associated with increased OS according to univariate and multivariate analyses. However, no significant differences in BCSS or OS were observed between the groups stratified by the number of positive lymph nodes. In conclusion, PMRT significantly improved OS for TNBC patients with T1-2 and 1-3 lymph nodes involved. Additional prospective studies are needed to provide a stronger evidence base for choosing patients for PMRT.
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