Post-Operative Radiation in Early Breast Cancer with N1 Disease: 10-Year Follow-Up

Post-operative radiotherapy for post-menopausal women with early breast cancer and N1 disease is controversial. Although locoregional control is improved, overall survival (OS) benefit is unclear. The clinical benefit of post-operative irradiation in this group of patients over 10 years was reviewed...

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Bibliographic Details
Published in:Diseases 2024-07, Vol.12 (7), p.145
Main Authors: Tang, Ee Ling Serene, Sim, E-Jan, Ang, Wei-Wen, Su, Jun, Chen, Juliana Jia Chuan, Chan, Mun Yew Patrick, Choo, Bok Ai, Tan, Ern Yu
Format: Article
Language:English
Subjects:
Breast cancer
Breast surgery
Cancer therapies
Care and treatment
Dissection
Endocrine therapy
Health aspects
Lumpectomy
Lymph nodes
Lymphatic system
Mastectomy
Menopause
Methods
nodal radiation
Patient outcomes
Patients
Post-menopause
Postmenopausal women
Postoperative care
Radiation therapy
Radiotherapy
recurrence
Risk factors
Software
Survival
Tumors
Womens health
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Summary:Post-operative radiotherapy for post-menopausal women with early breast cancer and N1 disease is controversial. Although locoregional control is improved, overall survival (OS) benefit is unclear. The clinical benefit of post-operative irradiation in this group of patients over 10 years was reviewed. We aimed to evaluate the OS, disease-free survival (DFS), and factors affecting OS and DFS. A retrospective review of 191 post-menopausal women with early breast cancer and N1 disease from 2004 to 2011 was performed. Demographics, post-operative histology, adjuvant treatment, OS, and DFS were evaluated. Post-operative radiation was given to 95 of 191 women (49.7%). Younger age at diagnosis ( < 0.001), a greater number of involved nodes ( = 0.004), lymphovascular invasion (LVI), and a higher tumor grade ( = 0.001) were more likely in women who received post-operative radiation. Nodal radiation did not improve 10-year DFS ( = 0.084) or OS ( = 0.203). Post-operative nodal radiation was associated with significant improvement in 10-year OS in women who received only hormonal therapy ( = 0.047) and no other systemic therapy. Women with unfavorable risk factors were more likely to receive post-operative radiation, likely due to a perceived higher risk of recurrence. Nodal radiation did not significantly improve 10-year DFS or OS in early breast cancer patients with N1 disease, and the benefit was not clearly demonstrated. However, in those who were on hormonal therapy, radiotherapy was beneficial in improving overall survival.
ISSN:2079-9721
2079-9721
DOI:10.3390/diseases12070145