scholarly journals Effect of postmastectomy radiotherapy on T1-2N1M0 triple-negative breast cancer

2021 ◽  
Author(s):  
Lin-Yu Xia ◽  
Wei-Yun Xu ◽  
Zhao Yan
Keyword(s):  
Breast Cancer ◽  
Triple Negative ◽  
Population Based ◽  
Positive Lymph Node ◽  
Breast Cancers ◽  
Cancer Specific Survival ◽  
Population Based Study ◽  
Postmastectomy Radiotherapy ◽  
Cox Proportional Hazard ◽  
Kaplan Meier

Abstract Background: The effect of postmastectomy radiotherapy (PMRT) on T1-2N1M0 triple-negative breast cancers (TNBC) remains unclear. The population-based study aimed to investigate the survival outcomes of T1-2N1M0 TNBC patients who underwent PMRT or not. Methods: We selected 1743 patients with T1-2N1M0 TNBC who underwent mastectomy between 2010 and 2015 through the Surveillance, Epidemiology and End Results (SEER) database. After propensity score matching (PSM) , the PMRT and no-PMRT groups consisted of 586 matched patients, respectively.The Kaplan-Meier method was applied to calculate breast cancer-specific survival (BCSS) and cox proportional hazard model were used to determine the prognostic factors of T1-2N1M0 TNBC.Results: The 5-year BCSS for the PMRT group and no-PMRT group was 79.1% and 74.7%, respectively. TNBC patients with stage T1-2N1M0 receiving PMRT did not show better BCSS than those did not (HR =0.800, 95% CI =0.605-1.056, P =0.115). Subgroup analysis showed that in patients with three nodes positive, radiotherapy could significantly improve BCSS(HR=0.396, 95% CI = 0.175-0.900, P = 0.027), but it brought no significant advantage in BCSS in patients with one or two nodes positive(HR =1.061, 95% CI =0.725-1.552, P =0.761; HR =0.657, 95% CI =0.405-1.065, P =0.088).In addition, PMRT improves the BCSS in TNBC patients with T2 tumor concomitant with three positive lymph nodes(HR =0.343, 95% CI =0.132-0.890, P =0.028).Conclusion: TNBC patients with T2 tumor concomitant with three positive lymph node can benefit from PMRT.

scholarly journals The effect of postmastectomy radiotherapy in node-positive triple-negative breast cancer

BMC Cancer ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Lei Zhang ◽  
Ru Tang ◽  
Jia-Peng Deng ◽  
Wen-Wen Zhang ◽  
Huan-Xin Lin ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Triple Negative ◽  
Cox Regression ◽  
Population Based ◽  
Breast Cancers ◽  
Cancer Specific Survival ◽  
Postmastectomy Radiotherapy ◽  
Pathological Staging ◽  
Node Positive ◽  
Advanced Tumor

Abstract Background The value of postmastectomy radiotherapy (PMRT) for pathological node-positive triple-negative breast cancers (TNBC) remains debatable. The aim of this population-based retrospective study was to evaluate the effect of PMRT on survival outcomes in this population. Methods Patients diagnosed with stage T1-4N1-N3M0 TNBC between 2010 and 2014 were identified from the Surveillance, Epidemiology, and End Results (SEER) database. We used univariate and multivariate Cox regression hazards method to determine the independent prognostic factors associated with 3-year breast cancer-specific survival (BCSS). The effect of PMRT on 3-year BCSS was analyzed after stratification by pathological staging of groups. Results Of the 4398 patients included in this study, 2649 (60.2%) received PMRT. Younger age, black ethnicity, and advanced tumor (T) and nodal (N) stage were the independent predictors associated with PMRT receipt (all P < 0.05). Patients who received PMRT showed better 3-year BCSS (OR = 0.720, 95% CI = 0.642–0.808, P < 0.001) than those that did not. The effect of PMRT on 3-year BCSS was analyzed after stratification by pathological staging of groups. The results showed that PMRT was associated with better 3-year BCSS in patients with stage T3–4N1 (P = 0.042), T1-4N2 (P < 0.001), and T1-4N3 (P < 0.001), while comparable 3-year BCSS was found between the PMRT and non-PMRT cohorts with T1–2N1 disease (P = 0.191). Conclusions Radiotherapy achieved better 3-year BCSS in TNBC patients with stage T3–4N1 and T1-4N2–3 disease. However, no survival benefit was found with the addition of PMRT in patients with T1–2N1 TNBC.

scholarly journals Radiotherapy after mastectomy has significant survival benefits for inflammatory breast cancer: a SEER population-based retrospective study

PeerJ ◽  
2020 ◽  
Vol 8 ◽  
pp. e8512
Author(s):  
Zhi-wen Li ◽  
Miao Zhang ◽  
Yong-jing Yang ◽  
Zi-jun Zhou ◽  
Yan-ling Liu ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Inflammatory Breast Cancer ◽  
Stage Iv ◽  
Population Based ◽  
Rank Test ◽  
Cancer Specific Survival ◽  
Cox Proportional Hazard ◽  
Kaplan Meier ◽  
Significant Survival ◽  
Study Population

Objectives The survival benefit of postmastectomy radiotherapy (PMRT) has not been fully proven in inflammatory breast cancer (IBC). Thus, in the present research, we aimed at elucidating the effects of PMRT on the survival of IBC patients. Methods Eligible patients were collected from the Surveillance, Epidemiology, and End Results (SEER) dataset between 2010 and 2013. The Kaplan-Meier method along with the log-rank test was utilized for the comparison of both the overall survival (OS) andthe cancer-specific survival (CSS) in patients undergoing PMRT or not. Additionally, multivariate survival analysis of CSS and OS were performed using the Cox proportional hazard model. Results In total, 293 eligible cases were identified, with the median follow-up time of 27 months (range: 5–59 months). After propensity score matching (PSM), 188 patients (94 for each) were classified intothe No-PMRT and the PMRT group. Consequently, significantly higher OS rates were detected in the PMRT group compared with the No-PMRT group prior to PSM (P = 0.034), and significantly higher CSS (P = 0.013) and OS (P = 0.0063) rates were observed following PSM. Furthermore, multivariate analysis revealed thatPMRT [CSS (HR: 0.519, 95% CI [0.287–0.939], P = 0.030); OS (HR: 0.480, 95% CI [0.269–0.859], P = 0.013)], as well as Her2+/HR+ subtype, was independent favorable prognostic factors.Besides, black ethnicity, AJCC stage IV and triple-negative subtype were independent unfavorable prognostic factors. Further subgroup analysis revealed that most of the study population could benefit from PMRT, no matter OS or CSS. Conclusions Our findings support that PMRT could improve the survival of IBC patients.

scholarly journals The different outcomes between breast-conserving surgery plus radiotherapy and mastectomy in metaplastic breast cancer: A population-based study

PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0256893
Author(s):  
Lin-Yu Xia ◽  
Wei-Yun Xu ◽  
Qing-Lin Hu
Keyword(s):  
Breast Cancer ◽  
Therapeutic Option ◽  
Breast Conserving Surgery ◽  
Population Based ◽  
Survival Outcomes ◽  
Metaplastic Breast Cancer ◽  
Cancer Specific Survival ◽  
Cox Proportional Hazard ◽  
Kaplan Meier ◽  
Surgical Methods

Background Metaplastic breast cancer (MBC) are rare. The survival outcomes of MBC patients after breast conserving surgery plus radiotherapy (BCS+RT) or mastectomy have not been established. The study aimed to compare survival outcomes of MBC patients subjected to BCS+RT or mastectomy therapeutic options. Methods Patients who were subjected to BCS+RT or mastectomy between 2004 and 2014 were enrolled in this study through the Surveillance, Epidemiology and End Results (SEER) database. Breast cancer-specific survival (BCSS) and the overall survival (OS) of the participants were determined. Cox proportional hazard model and the Kaplan Meier method were used to determine the correlation between the two surgical methods and survival outcomes. Results A total of 1197 patients were enrolled in this study. Among them, 439 patients were subjected to BCS+RT, while 758 patients were subjected to mastectomy. After propensity score matching (PSM), the BCS+RT and mastectomy groups consisted of 321 patients, respectively. The univariate and multivariate analysis with a 6-month landmark all indicate that patients receiving BCS+RT has higher OS than patients receiving mastectomy (HR = 0.701,95% CI = 0.496–0.990, P = 0.044; HR = 0.684,95% CI = 0.479–0.977, P = 0.037) while the BCSS was no difference between the two groups (HR = 0.739,95% CI = 0.474–1.153, P = 0.183; HR = 0.741,95% CI = 0.468–1.173, P = 0.200). Conclusion The BCS+RT therapeutic option exhibits a higher OS in MBC patients compared to the mastectomy approach.

scholarly journals Comparison of survival in non-metastatic inflammatory and other T4 breast cancers: a SEER population-based analysis

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Dechuang Jiao ◽  
Jingyang Zhang ◽  
Jiujun Zhu ◽  
Xuhui Guo ◽  
Yue Yang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cox Model ◽  
Survival Rates ◽  
Tumor Grade ◽  
Population Based ◽  
Rank Test ◽  
Breast Cancers ◽  
Significant Independent Predictor ◽  
Cancer Specific Survival ◽  
7Th Edition

Abstract Background Previous studies have reported poor survival rates in inflammatory breast cancer (IBC) patients than non-inflammatory local advanced breast cancer (non-IBC) patients. However, until now, the survival rate of IBC and other T4 non-IBC (T4-non-IBC) patients remains unexplored. Methods Surveillance, Epidemiology, and End Results (SEER) database was searched to identify cases with confirmed non-metastatic IBC and T4-non-IBC who had received surgery, chemotherapy, and radiotherapy between 2010 and 2015. IBC was defined as per the American Joint Committee on Cancer (AJCC) 7th edition. Breast Cancer-Specific Survival (BCSS) was estimated by plotting the Kaplan-Meier curve and compared across groups by using the log-rank test. Cox model was constructed to determine the association between IBC and BCSS after adjusting for age, race, stage of disease, tumor grade and surgery type. Results Out of a total of 1986 patients, 37.1% had IBC and mean age was 56.6 ± 12.4. After a median follow-up time of 28 months, 3-year BCSS rate for IBC and T4-non-IBC patients was 81.4 and 81.9%, respectively (log-rank p = 0.398). The 3-year BCSS rate in HR−/HER2+ cohort was higher for IBC patients than T4-non-IBC patients (89.5% vs. 80.8%; log-rank p = 0.028), and in HR−/HER2- cohort it was significantly lower for IBC patients than T4-non-IBC patients (57.4% vs. 67.5%; log-rank p = 0.010). However, it was identical between IBC and T4-non-IBC patients in both HR+/HER2- (85.0% vs. 85.3%; log-rank p = 0.567) and HR+/HER2+ (93.6% vs. 91.0%, log-rank p = 0.510) cohorts. After adjusting for potential confounding variables, we observed that IBC is a significant independent predictor for survival of HR−/HER2+ cohort (hazards ratio [HR] = 0.442; 95% CI: 0.216–0.902; P = 0.025) and HR−/HER2- cohort (HR = 1.738; 95% CI: 1.192–2.534; P = 0.004). Conclusions Patients with IBC and T4-non-IBC had a similar BCSS in the era of modern systemic treatment. In IBC patients, the HR−/HER2+ subtype is associated with a better outcome, and HR−/HER2- subtype is associated with poorer outcomes as compared to the T4-non-IBC patients.

Molecular Profile and Clinical Variables in Brca1-Positive Breast Cancers. A Population-Based Study

2005 ◽  
Vol 91 (6) ◽  
pp. 505-512 ◽  
Author(s):  
Antonino Musolino ◽  
Maria Michiara ◽  
Maria A. Bella ◽  
Nadia Naldi ◽  
Paola Zanelli ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Direct Sequencing ◽  
Population Based ◽  
Molecular Profile ◽  
Breast Cancers ◽  
Population Based Study ◽  
Free Survival ◽  
Molecular Features ◽  
Inherited Susceptibility ◽  
Brca1 Mutations

Purpose To evaluate the clinical features of breast cancer patients with genetic susceptibility to this disease and to investigate the contribution of BRCA1 germline mutations to the phenotype of these tumors. Patients and Methods We reviewed the clinical and pathological records of 102 women with suspected inherited susceptibility to breast cancer consecutively seen at the Genetic Oncology Service of Parma, Italy. Sixty-two patients with a high probability of harboring a germline, cancer-predisposing mutation were tested for BRCA1 mutations. Exon 11 was screened using the protein truncation test and detected mutations were confirmed by direct sequencing (DS). All other exons were analyzed by DS. Results Among the 62 patients with a completed mutation analysis, 48 (77.4%) had wild-type BRCA1, six (9.6%) had variants of unclear significance, eight (13%) had deleterious mutations. BRCA1-associated breast cancers (BABC) were significantly less likely to be diagnosed at stage I than breast cancers in women without mutations (12.5% vs 51%; P = 0.045), more likely to have a high proliferation rate (100% vs 24%, P<0.001), and more likely to be histological grade 3 (100% vs 14%, P<0.001), estrogen and progesterone receptor negative (87.5% vs 13%, P<0.001; 75% vs 23%, P = 0.004), and p53 positive (87.5% vs 30%, P = 0.023). All tumors with BRCA1 mutations were HER-2/neu negative compared with 57% of the non-BRCA1 tumors ( P = 0.04). There were no significant differences between BABC and non-BABC in 20-year relapse-free survival, 20-year event-free survival, and 20-year overall survival. Conclusion In this population-based study, BABC seems to present with adverse molecular features when compared with non-BABC, although the prognosis appears to be similar.

Influence of radiation therapy on the outcome of T1-2N0M0 triple-negative breast cancer: A SEER population-based retrospective analysis.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e12073-e12073
Author(s):  
Xiaoxiang Guan ◽  
Huan Li ◽  
Yajuan Chen ◽  
Xin Wang ◽  
Lin Tang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
Retrospective Analysis ◽  
Triple Negative Breast Cancer ◽  
Survival Benefit ◽  
Triple Negative ◽  
Breast Conservation ◽  
Population Based ◽  
Axillary Staging ◽  
Cancer Specific Survival

e12073 Background: For T1-2N0M0 breast cancer after surgery and axillary staging, the current NCCN guideline recommends radiation therapy (RT) after lumpectomy but not total mastectomy unless there is a positive or less than 1 mm negative margin. This recommendation is regardless of hormonal status. Triple-negative breast cancer is a generally considered more aggressive compared with hormone positive breast cancer. We sought to investigate whether there is a survival benefit of RT in T1-2N0M0 TNBC. Methods: A Population-based retrospective analysis was performed using the Surveillance, Epidemiology, and End Results (SEER) database. Patients included in the analysis were divided into three groups according to surgery modality and RT: breast conservation therapy (BCT, i.e., lumpectomy + RT), mastectomy alone, and mastectomy + RT. The survival endpoints were breast cancer-specific survival (BCSS) and overall survival (OS), and survival analysis was performed using the Kaplan-Meier method. Results: A total of 22473 female with T1-2N0M0 TNBC diagnosed between 2010 and 2015 were included, with 13395 (60%) T1 and 9078 (40%) T2 cases. Surgery, RT and chemotherapy was done in 21674 (96%), 9633 (43%) and 14651 (65%) patients, respectively. Patients who underwent RT were older ( > 50 years, 78% vs 72%, P< 0.001), had fewer T2 (35% vs 44%, P< 0.001) tumor, and had more chemotherapy utilization (72% vs 60%, P< 0.001). 8807 patients had BCT; 8329 had mastectomy alone and 635 had mastectomy + RT. The 5-year BCSS rate was 94.3% for BCT, 93.3% for mastectomy alone ( P= 0.009 vs BCT), and 83.7% for mastectomy + RT ( P< 0.001 vs BCT and P< 0.001 vs mastectomy alone), respectively. The 5-year OS rate was 88.6% for BCT, 83.0 % for mastectomy alone ( P< 0.001 vs BCT), and 79.6% for mastectomy + RT ( P< 0.001 vs BCT and P= 0.190 vs mastectomy alone), respectively. Conclusions: In patients with T1-2N0M0 TNBC, BCT was associated with superior BCSS and OS compared to mastectomy with or without RT. After mastectomy, there was no evidence of survival benefit of RT, with worse BCSS and similar OS.

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