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Postmastectomy Radiation Therapy for Node-Negative Breast Cancer of 5 cm or Larger Tumors: A Multicenter Retrospective Analysis (KROG 20-03)

 Kyubo Kim  ;  Jinhong Jung  ;  Haeyoung Kim  ;  Wonguen Jung  ;  Kyung Hwan Shin  ;  Ji Hyun Chang  ;  Su Ssan Kim  ;  Won Park  ;  Jee Suk Chang  ;  Yong Bae Kim  ;  Sung Ja Ahn  ;  Ik Jae Lee  ;  Jong Hoon Lee  ;  Hae Jin Park  ;  Jihye Cha  ;  Juree Kim  ;  Jin Hwa Choi  ;  Taeryool Koo  ;  Jeanny Kwon  ;  Jin Hee Kim  ;  Mi Young Kim  ;  Shin-Hyung Park  ;  Yeon-Joo Kim 
 CANCER RESEARCH AND TREATMENT, Vol.54(2) : 497-504, 2022-04 
Journal Title
Issue Date
Breast Neoplasms* / radiotherapy ; Breast Neoplasms* / surgery ; Female ; Humans ; Mastectomy ; Neoplasm Recurrence, Local / pathology ; Neoplasm Staging ; Radiotherapy, Adjuvant ; Retrospective Studies
Breast neoplasms ; Mastectomy ; Node-negative ; Radiotherapy ; ≥5cm
Purpose: To evaluate the role of postmastectomy radiation therapy (PMRT) in patients with node-negative breast cancer of 5cm or larger tumors undergoing mastectomy.

Materials and methods: Medical records of 274 patients from 18 institutions treated with mastectomy between January 2000 and December 2016 were retrospectively reviewed. Among these, 202 patients underwent PMRT, while 72 did not. Two hundred and forty-one patients (88.0%) received systemic chemotherapy, and 172 (62.8%) received hormonal therapy. Patients receiving PMRT were younger, more likely to have progesterone receptor-positive tumors, and received adjuvant chemotherapy more frequently compared with those without PMRT (p <0.001, 0.018, and <0.001, respectively). Other characteristics were not significantly different between the two groups.

Results: With a median follow-up of 95 months (range, 1-249), there were 9 locoregional recurrences, and 20 distant metastases. The 8-year locoregional recurrence-free survival rates were 98.0% with PMRT and 91.3% without PMRT (p=0.133), and the 8-year disease-free survival (DFS) rates were 91.8% with PMRT and 73.9% without PMRT (p=0.008). On multivariate analysis incorporating age, histologic grade, lymphovascular invasion, hormonal therapy, chemotherapy, and PMRT, the absence of lymphovascular invasion and the receipt of PMRT were associated with improved DFS (p=0.025 and 0.009, respectively).

Conclusion: Locoregional recurrence rate was very low in node-negative breast cancer of 5cm or larger tumors treated with mastectomy regardless of the receipt of PMRT. However, PMRT was significantly associated with improved DFS. Further investigation is needed to confirm these findings.
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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
Lee, Ik Jae(이익재) ORCID logo https://orcid.org/0000-0001-7165-3373
Chang, Jee Suk(장지석) ORCID logo https://orcid.org/0000-0001-7685-3382
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