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, Yongbae Kim, Sung Ja Ahn, Jong Hoon Lee, Jin Hee Kim, Mison Chun, Hyung Sik Lee, Jung Soo Kim, Jihye Cha

Research output: Contribution to journalArticle

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

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Segmental Mastectomy
Anthracyclines
Mastectomy
Multicenter Studies
Modified Radical Mastectomy
Radiotherapy
Retrospective Studies
Breast Neoplasms
Drug Therapy
Survival
Propensity Score
taxane
Radiation Pneumonitis
Lymphedema
Disease-Free Survival
Medical Records

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

Cite this

Yoo, Gyu Sang ; Park, Won ; Yu, Jeong Il ; Choi, Doo Ho ; Kim, Yeon Joo ; Shin, Kyung Hwan ; Wee, Chan Woo ; Kim, Kyubo ; Park, Kyung Ran ; Kim, Yongbae ; Ahn, Sung Ja ; Lee, Jong Hoon ; Kim, Jin Hee ; Chun, Mison ; Lee, Hyung Sik ; Kim, Jung Soo ; Cha, Jihye. / 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). In: Cancer Research and Treatment. 2019 ; Vol. 51, No. 3. pp. 1041-1051.
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title = "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)",
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.",
author = "Yoo, {Gyu Sang} and Won Park and Yu, {Jeong Il} and Choi, {Doo Ho} and Kim, {Yeon Joo} and Shin, {Kyung Hwan} and Wee, {Chan Woo} and Kyubo Kim and Park, {Kyung Ran} and Yongbae Kim and Ahn, {Sung Ja} and Lee, {Jong Hoon} and Kim, {Jin Hee} and Mison Chun and Lee, {Hyung Sik} and Kim, {Jung Soo} and Jihye Cha",
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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). / Yoo, Gyu Sang; Park, Won; Yu, Jeong Il; Choi, Doo Ho; Kim, Yeon Joo; Shin, Kyung Hwan; Wee, Chan Woo; Kim, Kyubo; Park, Kyung Ran; Kim, Yongbae; Ahn, Sung Ja; Lee, Jong Hoon; Kim, Jin Hee; Chun, Mison; Lee, Hyung Sik; Kim, Jung Soo; Cha, Jihye.

In: Cancer Research and Treatment, Vol. 51, No. 3, 01.07.2019, p. 1041-1051.

Research output: Contribution to journalArticle

TY - JOUR

T1 - 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

T2 - A multicenter retrospective study (KROG 1418)

AU - Yoo, Gyu Sang

AU - Park, Won

AU - Yu, Jeong Il

AU - Choi, Doo Ho

AU - Kim, Yeon Joo

AU - Shin, Kyung Hwan

AU - Wee, Chan Woo

AU - Kim, Kyubo

AU - Park, Kyung Ran

AU - Kim, Yongbae

AU - Ahn, Sung Ja

AU - Lee, Jong Hoon

AU - Kim, Jin Hee

AU - Chun, Mison

AU - Lee, Hyung Sik

AU - Kim, Jung Soo

AU - Cha, Jihye

PY - 2019/7/1

Y1 - 2019/7/1

N2 - 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.

AB - 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.

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DO - 10.4143/crt.2018.424

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SN - 1598-2998

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