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Outcome After Conservative Surgery and Breast Irradiation in 5,717 Patients With Breast Cancer: Implications for Supraclavicular Nodal Irradiation

Authors :
Livi, Lorenzo
Scotti, Vieri
Saieva, Calogero
Meattini, Icro
Detti, Beatrice
Simontacchi, Gabriele
Cardillo, Carla Deluca
Paiar, Fabiola
Mangoni, Monica
Marrazzo, Livia
Agresti, Benedetta
Cataliotti, Luigi
Bianchi, Simonetta
Biti, Giampaolo
Source :
International Journal of Radiation Oncology, Biology, Physics. Mar2010, Vol. 76 Issue 4, p978-983. 6p.
Publication Year :
2010

Abstract

Purpose: To evaluate the outcome and predictive factors of patients who underwent breast-conserving surgery and adjuvant radiotherapy to the whole breast only, without supraclavicular nodal irradiation. Methods and Materials: A total of 5,717 patients with pT1–T4 breast cancer were treated at the University of Florence. The median age of the patient population was 55 years (range, 30–80 years). All patients were followed for a median of 6.8 years (range, 1–27 years). Adjuvant chemotherapy was recommended in 1,535 patients (26.9%). Tamoxifen was prescribed in 2,951 patients (51.6%). The patients were split into three groups according to number of positive axillary nodes (PAN): P1, negative axillary lymph nodes; P2, one to three PAN; P3, more than three PAN. Results: The P3 patients had a higher incidence of supraclavicular fossa recurrence (SFR) compared with P2 and P1 patients. However, the incidence of SFR in P3 patients was low (only 5.5%), whereas the incidence of distant metastases (DM) was 27.2%. Distant metastasis was the only independent prognostic factor for breast cancer survival. Additionally, in the subgroup of patients who developed local recurrence, DM was the most important death predictor. Conclusion: Our series suggests that isolated SFR in patients who did not receive supraclavicular radiotherapy is infrequent, as well as in those patients who have more than three PAN, and SFR seems not to influence the outcome, which depends on DM occurrence. [Copyright &y& Elsevier]

Details

Language :
English
ISSN :
03603016
Volume :
76
Issue :
4
Database :
Academic Search Index
Journal :
International Journal of Radiation Oncology, Biology, Physics
Publication Type :
Academic Journal
Accession number :
48541592
Full Text :
https://doi.org/10.1016/j.ijrobp.2009.03.001