Youssef H Zeidan1, Joyce G Habib2, Lieveke Ameye3, Marianne Paesmans3, Evandro de Azambuja4, Richard D Gelber5, Ian Campbell6, Bo Nordenskjöld7, Jorge Gutiérez8, Michael Anderson9, Ana Lluch10, Michael Gnant11, Aron Goldhirsch12, Angelo Di Leo13, David J Joseph14, John Crown15, Martine Piccart-Gebhart16, Prudence A Francis17. 1. Department of Radiation Oncology, American University of Beirut Medical Center, Beirut, Lebanon. Electronic address: yz09@aub.edu.lb. 2. Department of Medical Oncology, Fouad Khoury and Makassed General Hospital, Beirut, Lebanon. 3. Data Centre, Jules Bordet Institute, Université Libre de Bruxelles, Brussels, Belgium. 4. Medical Oncology Clinic, Université Libre de Bruxelles, Brussels, Belgium. 5. IBCSG Statistical Center, Dana-Farber Cancer Institute, Harvard T. H. Chan School of Public Health, Harvard Medical School, and Frontier Science and Technology Research Foundation, Boston, Massachusetts. 6. Department of Surgery, Waikato Hospital, University of Auckland School of Health Sciences, Hamilton, New Zealand. 7. Swedish Breast Cancer Group and Department of Oncology, Linköping University, Linköping, Sweden. 8. Grupo Oncologico Cooperativo Chileno De Investigacion, Clinica Las Condes, Santiago, Chile. 9. Department of Oncology, Copenhagen University Hospital Rigshospitalet, and Danish Breast Cancer Cooperative Group, Copenhagen, Denmark. 10. Department of Hematology and Medical Oncology, Hospital Clínico Universitario de Valencia/INCLIVA, Universidad de Valencia, Valencia, Spain (on behalf the Grupo Español de Investigación en Cáncer de Mama). 11. Department of Surgery and Comprehensive Cancer Center, Medical University of Vienna, and Austrian Breast and Colorectal Cancer Study Group, Vienna, Austria. 12. European Institute of Oncology, Milan, Italy; International Breast Cancer Study Group, Bern, Switzerland. 13. Sandro Pitigliani' Medical Oncology Department, Hospital of Prato, Istituto Toscano Tumori, Prato, Italy. 14. Department of Radiation Oncology, Sir Charles Gairdner Hospital, University of Western Australia, Genesis Cancer Care, Edith Cowan University, and Breast Cancer Trials Australia & New Zealand, Perth, Australia. 15. Department of Medical Oncology, St. Vincent's University Hospital, Dublin, Ireland. 16. Department of Medicine, Université Libre de Bruxelles, Brussels, Belgium. 17. International Breast Cancer Study Group, Bern, Switzerland; Peter MacCallum Cancer Centre, Melbourne, Australia; St. Vincents's Hospital, University of Melbourne, Australia; Breast Cancer Trials Australia & New Zealand, University of Newcastle, Newcastle, Australia.
Abstract
PURPOSE: To analyze the impact of postmastectomy radiation therapy (PMRT) for patients with T1-T2 tumors and 1 to 3 positive lymph nodes enrolled on the Breast International Group (BIG) 02-98 trial. METHODS AND MATERIALS: The BIG 02-98 trial randomized patients to receive adjuvant anthracycline with or without taxane chemotherapy. Delivery of PMRT was nonrandomized and performed according to institutional preferences. The present analysis was performed on participants with T1-T2 breast cancer and 1 to 3 positive lymph nodes who had undergone mastectomy and axillary nodal dissection. The primary objective of the present study was to examine the effect of PMRT on risk of locoregional recurrence (LRR), breast cancer-specific survival, and overall survival. RESULTS: We identified 684 patients who met the inclusion criteria and were included in the analysis, of whom 337 (49%) had received PMRT. At 10 years, LRR risk was 2.5% in the PMRT group and 6.5% in the no-PMRT group (hazard ratio 0.29, 95% confidence interval 0.12-0.73; P = .005). Lower LRR after PMRT was noted for patients randomized to receive adjuvant chemotherapy with no taxane (10-year LRR: 3.4% vs 9.1%; P = .02). No significant differences in breast cancer-specific survival (84.3% vs 83.9%) or overall survival (81.7% vs 78.3%) were observed according to receipt of PMRT. CONCLUSION: Our analysis of the BIG 02-98 trial shows excellent outcomes in women with T1-T2 tumors and 1 to 3 positive lymph nodes found in axillary dissection. Although PMRT improved LRR in this cohort, the number of events remained low at 10 years. In all groups, 10-year rates of LRR were relatively low compared with historical studies. As such, the use of PMRT in women with 1 to 3 positive nodes should be tailored to individual patient risks.
PURPOSE: To analyze the impact of postmastectomy radiation therapy (PMRT) for patients with T1-T2 tumors and 1 to 3 positive lymph nodes enrolled on the Breast International Group (BIG) 02-98 trial. METHODS AND MATERIALS: The BIG 02-98 trial randomized patients to receive adjuvant anthracycline with or without taxane chemotherapy. Delivery of PMRT was nonrandomized and performed according to institutional preferences. The present analysis was performed on participants with T1-T2 breast cancer and 1 to 3 positive lymph nodes who had undergone mastectomy and axillary nodal dissection. The primary objective of the present study was to examine the effect of PMRT on risk of locoregional recurrence (LRR), breast cancer-specific survival, and overall survival. RESULTS: We identified 684 patients who met the inclusion criteria and were included in the analysis, of whom 337 (49%) had received PMRT. At 10 years, LRR risk was 2.5% in the PMRT group and 6.5% in the no-PMRT group (hazard ratio 0.29, 95% confidence interval 0.12-0.73; P = .005). Lower LRR after PMRT was noted for patients randomized to receive adjuvant chemotherapy with no taxane (10-year LRR: 3.4% vs 9.1%; P = .02). No significant differences in breast cancer-specific survival (84.3% vs 83.9%) or overall survival (81.7% vs 78.3%) were observed according to receipt of PMRT. CONCLUSION: Our analysis of the BIG 02-98 trial shows excellent outcomes in women with T1-T2 tumors and 1 to 3 positive lymph nodes found in axillary dissection. Although PMRT improved LRR in this cohort, the number of events remained low at 10 years. In all groups, 10-year rates of LRR were relatively low compared with historical studies. As such, the use of PMRT in women with 1 to 3 positive nodes should be tailored to individual patient risks.
Authors: Maria Cristina Leonardi; Ida Rosalia Scognamiglio; Barbara Alicja Jereczek-Fossa; Giovanni Corso; Patrick Maisonneuve; Samantha Dicuonzo; Damaris Patricia Rojas; Maria Alessia Zerella; Anna Morra; Marianna Alessandra Gerardi; Mattia Zaffaroni; Alessandra De Scalzi; Antonia Girardi; Francesca Magnoni; Emilia Montagna; Cristiana Iuliana Fodor; Viviana Enrica Galimberti; Paolo Veronesi; Roberto Orecchia; Roberto Pacelli Journal: Breast Cancer Res Treat Date: 2021-04-27 Impact factor: 4.872
Authors: Nalee Kim; Haeyoung Kim; Won Park; Doo Ho Choi; Won Kyung Cho; Seok Jin Nam; Jeong Eon Lee; Seok Won Kim; Jonghan Yu; Sei Kyung Lee; Byung-Joon Jeon; Jai Kyong Pyon; Goo-Hyun Mun; Tae Gyu Kim Journal: Breast Cancer Res Treat Date: 2022-01-16 Impact factor: 4.872