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Internal mammary node irradiation in node-positive breast cancer treated with mastectomy and taxane-based chemotherapy

Authors
 Won Kyung Cho  ;  Jee Suk Chang  ;  Seung Gyu Park  ;  Nalee Kim  ;  Doo Ho Choi  ;  Haeyoung Kim  ;  Yong Bae Kim  ;  Won Park  ;  Chang Ok Suh 
Citation
 BREAST, Vol.59 : 37-43, 2021-10 
Journal Title
BREAST
ISSN
 0960-9776 
Issue Date
2021-10
MeSH
Breast Neoplasms* / drug therapy ; Chemotherapy, Adjuvant ; Disease-Free Survival ; Female ; Humans ; Lymph Nodes ; Mastectomy* ; Neoplasm Recurrence, Local ; Retrospective Studies ; Taxoids / therapeutic use
Keywords
Internal mammary node ; Radiation ; Regional lymph node irradiation
Abstract
Background: It is important to continually reevaluate the risk/benefit calculus of internal mammary node irradiation (IMNI) in the era of modern systemic therapy. We aimed to investigate the effect of IMNI on survival in node-positive breast cancer treated with mastectomy and anthracycline plus taxane-based chemotherapy.

Methods: We analyzed 348 patients who underwent mastectomy and anthracycline plus taxane-based chemotherapy for node-positive breast cancer between January 2006 and December 2011. All patients received postoperative radiation therapy (RT) with IMNI (n = 105, 30.2%) or without IMNI (n = 243, 69.8%). The benefit of IMNI for disease-free survival (DFS) and overall survival (OS) was evaluated using multivariate analysis and inverse probability of treatment weighting (IPTW) to adjust for unbalanced covariates between the groups.

Results: After a median follow-up of 95 months, the 10-year locoregional recurrence-free survival rate, DFS, and OS in all patients were 94.8%, 77.4%, and 86.2%, respectively. The IPTW-adjusted hazard ratio (HR) for the association of IMNI (vs. no IMNI) with DFS and OS was 0.208 (95% confidence intervals (CI) 0.045-0.966) and 0.460 (95% CI, 0.220-0.962), respectively. In multivariate analysis, IMNI was a favorable factor for DFS (HR, 0.458; P = 0.021) and OS (HR 0.233, P = 0.018).

Conclusions: IMNI was associated with improved DFS and OS in node-positive patients treated with mastectomy, post-mastectomy RT, and taxane-based chemotherapy, although the rate of locoregional recurrence was low.
Files in This Item:
T202104781.pdf Download
DOI
10.1016/j.breast.2021.05.012
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
Yonsei Authors
Kim, Yong Bae(김용배) ORCID logo https://orcid.org/0000-0001-7573-6862
Chang, Jee Suk(장지석) ORCID logo https://orcid.org/0000-0001-7685-3382
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/186880
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