Efficacy of post‑mastectomy radiotherapy in patients with T1‑2N1 breast cancer aged ≤35 years or with a positive HER‑2 status

Wang,Mincong; Wang,Yali; Xie,Fei; Ren,Hongtao; Chen,Jing; Wang,Zhongwei

doi:10.3892/mco.2023.2654

Efficacy of post‑mastectomy radiotherapy in patients with T1‑2N1 breast cancer aged ≤35 years or with a positive HER‑2 status

Authors:
- Mincong Wang
- Yali Wang
- Fei Xie
- Hongtao Ren
- Jing Chen
- Zhongwei Wang
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Affiliations: Department of Radiotherapy, Second Affiliated Hospital, Medical School of Xi'an Jiaotong University, Xi'an, Shaanxi 710004, P.R. China, Department of Neurosurgery, Xi'an Central Hospital, Medical School of Xi'an Jiaotong University, Xi'an, Shaanxi 710003, P.R. China
Published online on: June 15, 2023 https://doi.org/10.3892/mco.2023.2654
Article Number: 58
Copyright: © Wang et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Post‑mastectomy radiotherapy (PMRT) is highly recommended for patients with breast cancer with one to three positive nodes; however, there remains some controversy regarding its use. The present retrospective study aimed to explore which patients may be able to avoid PMRT and its associated side effects. A total of 728 patients with T1‑2N1 breast cancer who were treated with or without PMRT were included in the present study. The results suggested that PMRT significantly decreased the locoregional recurrence rate (LRR) [hazard ratio (HR)=5.602, 95% confidence interval (CI)=3.139‑9.998, P<0.01; 3‑year LRR: 4 vs. 17%] and improved overall survival (OS) (HR=0.651, 95% CI=0.437‑0.971, P=0.03; 3‑year OS: 91 vs. 87%) for patients with T1‑2N1 breast cancer. By contrast, PMRT had no significant effect on the distant metastasis (DM) rate (HR=0.691, 95% CI=0.468‑1.019, P=0.06; 3‑year DM: 10 vs. 15%). Further stratified analysis revealed that PMRT did not reduce the LRR and DM, or improve OS in patients aged ≤35 years or in those with a positive human epidermal growth factor receptor‑2 (HER‑2) status. The analysis of 438 patients treated with PMRT revealed that patients aged ≤35 years or those with a positive HER‑2 status were more likely to experience local recurrence even following PMRT. Thus, the benefits of using PMRT in patients with T1‑2N1 breast cancer who are aged ≤35 years or in those with a positive HER‑2 status need to be carefully considered. Further studies are required to confirm whether this patient group may be exempted from PMRT.

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