Evaluation of the Role of Postmastectomy Radiotherapy in Women with One to Three Positive Auxillary Nodes with Extracapsular Invasion

Nabila Hezi. MD, Nadia Ali. MD

Abstract: Background There is insufficient evidence to suggest the routine use of postmastectomy radiotherapy (PMRT) in women with T1-T2 breast carcinoma and 1-3 positive lymph nodes with extracapsular invasion (ECI). PURPOSE To determine whether PMRT after adjuvant chemotherapy will reduce the risk of loco-regional recurrence (LRR) and thus improve survival, in this group of patients. Patients and methods Between May 2010 and December 2015, 64 women with pathologic T1-T2 breast carcinoma and 1-3 positive nodes with ECI, and who had undergone modified radical mastectomy and received adjuvant chemotherapy, were randomized to PMRT (group A, n=32) or no adjuvant radiotherapy (group B, n=32). Loco-regional radiotherapy schedule was 50 Gy in 25 fractions over 5 weeks. The median Follow-up period was 50 months (range, 35-66). Results The two treatment groups were well balanced with respect to the known prognostic factors. Out of 64 patients, 53 % were 0.05). The 5-year overall survival rates were 96 % and 93 % of patients in group A and group B, respectively (P > 0.05). Univariate analysis failed to show any impact of prognostic factors on local recurrence free survival, distant metastasis free survival or overall survival. Three patients in group A and one in group B developed grade-3 lymphedema. None of the patients have developed radiation pneumonitis, brachial plexopathy or cardiac events. Conclusion In women with T1-T2 breast carcinoma and 1-3 positive lymph nodes with ECI, significantly lower LRR was observed with PMRT than without adjuvant radiotherapy. Further trials with a larger number of patients and longer follow-up periods are needed to optimize loco-regional control and potentially improve survival in this group of patients.

Keywords: Breast cancer, Post-mastectomy radiotherapy, 1-3 positive nodes, Extracapsular invasion

How to Cite?: Nabila Hezi. MD, Nadia Ali. MD, "Evaluation of the Role of Postmastectomy Radiotherapy in Women with One to Three Positive Auxillary Nodes with Extracapsular Invasion", Volume 5 Issue 8, August 2016, International Journal of Science and Research (IJSR), Pages: 1309-1313, https://www.ijsr.net/getabstract.php?paperid=ART2016530, DOI: https://dx.doi.org/10.21275/ART2016530

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