No clear effect of postoperative radiotherapy on survival of breast cancer patients with one to three positive nodes: a population-based study
2015 (English)In: Annals of Oncology, ISSN 0923-7534, E-ISSN 1569-8041, Vol. 26, no 6, 1149-1154 p.Article in journal (Refereed) Published
Background: In published radiotherapy trials, the failure rate in the control arm among patients with one to three positive nodes is high compared with that seen with modern adjuvant treatments. Therefore, the generalizability of the results has been questioned. The aim of the present study was to compare relative survival in breast cancer patients between two Swedish regions with screening mammography programs and adjuvant treatment guidelines similar with the exception of the indication of radiotherapy for patients with one to three positive nodes. Patients and methods: Between 1989 and 2006, breast cancer patients were managed very similarly in the west and southeast regions, except for indication for postoperative radiotherapy. In patients with one to three positive nodes, post-mastectomy radiotherapy was generally given in the southeast region (89% of all cases) and generally not given in the west region (15% of all cases). For patients with one to three positive nodes who underwent breast-conserving surgery, patients in the west region had breast radiotherapy only, while patients in the southeast region had both breast and lymph nodes irradiated. Results: The 10-year relative survival for patients with one to three positive lymph nodes was 78% in the west region and 77% in the southeast region (P = 0.12). Separate analyses depending on type of surgery, as well as number of examined nodes, also revealed similar relative survival. Conclusion: Locoregional postoperative radiotherapy has well-known side-effects, but in this population-based study, there was little or no influence of this type of radiotherapy on survival when one to three lymph nodes were involved.
Place, publisher, year, edition, pages
Oxford University Press (OUP): Policy B - Oxford Open Option F , 2015. Vol. 26, no 6, 1149-1154 p.
postoperative radiotherapy; breast cancer; positive nodes
Cancer and Oncology
IdentifiersURN: urn:nbn:se:liu:diva-120464DOI: 10.1093/annonc/mdv159ISI: 000357997500016PubMedID: 25839671OAI: oai:DiVA.org:liu-120464DiVA: diva2:845560