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No clear effect of postoperative radiotherapy on survival of breast cancer patients with one to three positive nodes: a population-based study
Southern Alvsborg Hospital, Sweden; Sahlgrens University Hospital, Sweden.
Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Region Östergötland, Center for Health and Developmental Care, Regional Cancer Center South East Sweden. Linköping University, Faculty of Medicine and Health Sciences. Regional Cancer Centre South East Sweden, Linkoping, Sweden.
Sahlgrens University Hospital, Sweden.
Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Surgery in Linköping.
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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
Abstract [en]

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.
Keyword [en]
postoperative radiotherapy; breast cancer; positive nodes
National Category
Cancer and Oncology
Identifiers
URN: urn:nbn:se:liu:diva-120464DOI: 10.1093/annonc/mdv159ISI: 000357997500016PubMedID: 25839671OAI: oai:DiVA.org:liu-120464DiVA: diva2:845560
Available from: 2015-08-12 Created: 2015-08-11 Last updated: 2016-04-11

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Fohlin, HelenaArnesson, Lars-GunnarNordenskjöld, Bo
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Division of Clinical SciencesRegional Cancer Center South East SwedenFaculty of Medicine and Health SciencesDepartment of Surgery in LinköpingDepartment of Oncology
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Annals of Oncology
Cancer and Oncology

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