Breast
Author:
Keywords:
Science & Technology, Life Sciences & Biomedicine, Oncology, Obstetrics & Gynecology, Breast cancer, Radiotherapy, Mastectomy, Locoregional recurrence, Prognostic scoring system, RADIOTHERAPY, AXILLARY, MASTECTOMY, WOMEN, RISK, TUMOR, PREDICTIONS, DIAGNOSIS, MORTALITY, SURVIVAL, Breast Neoplasms, Female, Humans, Neoplasm Recurrence, Local, Neoplasm Staging, Prognosis, Radiotherapy, Adjuvant, Retrospective Studies, 1103 Clinical Sciences, 1117 Public Health and Health Services, Oncology & Carcinogenesis, 3202 Clinical sciences, 3211 Oncology and carcinogenesis
Abstract:
BACKGROUND: To date, it remains unclear which patients with breast cancer (BC) benefit from post-mastectomy radiotherapy (PMRT). Cheng et al. developed and validated a scoring system based on 4 prognostic factors for locoregional recurrence (LRR) to identify patients in need for PMRT. These factors include age, estrogen receptor status, lymphovascular status and number of affected axillary lymph nodes. PURPOSE: To validate the scoring system for LRR in BC developed by Cheng et al. by using an independent BC database. METHODS AND MATERIALS: We retrospectively identified 1989 BC cases, treated with mastectomy (ME) with or without PMRT at the University Hospitals Leuven between 2000 and 2007. The primary endpoint was 5-year locoregional control rate with and without PMRT, according to the LRR score. RESULTS: Median follow-up time was 11.4 years. After excluding patients with missing variables 1103 patients were classified using the LRR scoring system: 688 (62.38%) patients were at low risk of recurrence (LRR score 0-1), 335 (30.37%) patients were at intermediate risk of recurrence (LRR score 2-3) and 80 (7.25%) patients were at high risk of recurrence (LRR score ≥4). 5-year locoregional control rates with and without PMRT were 99.20% versus 99.21% (p = 0.43) in the low-risk group; 98.24% versus 85.74% (p < 0.0001) in the intermediate-risk group and 96.87% versus 85.71% (p = 0.10) in the high-risk group respectively. CONCLUSION: Our validation of the LRR scoring system suggests it can be used to point out patients that would benefit from PMRT. We recommend further validation of this scoring system by other independent institutions before application in clinical practice.