Comparison of breast conserving surgery followed by radiation therapy with mastectomy alone for pathologic N1 breast cancer patients in the era of anthracycline plus taxane-based chemotherapy: A multicenter retrospective study (KROG 1418)

Gyu Sang Yoo, Won Park, Jeong Il Yu, Doo Ho Choi, Yeon Joo Kim, Kyung Hwan Shin, Chan Woo Wee, Kyubo Kim, Kyung Ran Park, Yong Bae Kim, Sung Ja Ahn, Jong Hoon Lee, Jin Hee Kim, Mison Chun, Hyung Sik Lee, Jung Soo Kim, Jihye Cha

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Abstract

Purpose We compared the oncologic outcomes of breast-conserving surgery plus radiation therapy (BCS+RT) and modified radical mastectomy (MRM) under anthracycline plus taxane-based (AT) regimens and investigated the role of adjuvant radiation therapy (RT) in patients with pathologic N1 (pN1) breast cancer treated by mastectomy. Materials and Methods We retrospectively reviewed the medical records of 2,011 patients with pN1 breast cancer who underwent BCS+RT or MRM alone at 12 institutions between January 2006 and December 2010. Two-to-one propensity score matching was performed for balances in variables between the groups. Results The median follow-up duration for the total cohort was 69 months (range, 1 to 114 months). After propensity score matching, 1,074 patients (676 in the BCS+RT group and 398 in the MRM-alone group) were analyzed finally. The overall survival, disease-free survival, locoregional failure-free survival, and regional failure-free survival (RFFS) curves of the BCS+RT group vs. MRM-alone group were not significantly different. The subgroup analysis revealed that in the group with both lymphovascular invasion (LVI) and histologic grade (HG) III, the BCS+RT showed significantly superior RFFS (p=0.008). Lymphedema (p=0.007) and radiation pneumonitis (p=0.031) occurred more frequently in the BCS+RT group than in the MRM-alone group, significantly. Conclusion There are no differences in oncologic outcomes between BCS+RT and MRM-alone groups under the AT chemotherapy regimens for pN1 breast cancer. However, BCS+RT group showed superior RFFS to MRM-alone group in the patients with LVI and HG III. Adjuvant RT might be considerable for pN1 breast cancer patients with LVI and HG III.

Original languageEnglish
Pages (from-to)1041-1051
Number of pages11
JournalCancer Research and Treatment
Volume51
Issue number3
DOIs
Publication statusPublished - 2019 Jul 1

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

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    Yoo, G. S., Park, W., Yu, J. I., Choi, D. H., Kim, Y. J., Shin, K. H., Wee, C. W., Kim, K., Park, K. R., Kim, Y. B., Ahn, S. J., Lee, J. H., Kim, J. H., Chun, M., Lee, H. S., Kim, J. S., & Cha, J. (2019). Comparison of breast conserving surgery followed by radiation therapy with mastectomy alone for pathologic N1 breast cancer patients in the era of anthracycline plus taxane-based chemotherapy: A multicenter retrospective study (KROG 1418). Cancer Research and Treatment, 51(3), 1041-1051. https://doi.org/10.4143/crt.2018.424