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Locoregional recurrence patterns in women with breast cancer who have not undergone post-mastectomy radiotherapy
Ye-Xiong Li
Chinese Academy of Medical Sciences and Peking Union Medical College
Corresponding Author
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This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at Radiation Oncology.
Background : To analyze the patterns of locoregional recurrence in breast cancer patients after mastectomy.
Methods : The retrospective study included 7073 women with breast cancer without post-mastectomy radiotherapy: 4604 (65.1%) had pT1-2N0 disease (low risk); 2042 (28.9%), pT1-2N1 (intermediate risk); and 427 (6.0%), pT3-4 and/or pN2-3, or pT1-2N1 after neoadjuvant chemotherapy (high risk). The distribution of cumulative locoregional recurrence was analyzed. The local recurrence and regional recurrence rates were estimated by the Kaplan-Meier method, and differences were compared with the log-rank test. Multivariate analysis was performed using Cox logistic regression analysis.
Results: In the median follow-up of 63.0 months, 469 patients had locoregional recurrence: chest wall recurrence in 238 cases (50.7%), supraclavicular/infraclavicular nodes in 236 (50.3%) cases, axilla in 92 (19.6%), and internal mammary nodes in 50 (10.7%) cases. The 5-year local recurrence and regional recurrence rates were 2.5% and 4.4%, respectively. Subgroup analysis of the three risk groups and five molecular subtypes (luminal A, luminal B-Her2 negative, luminal B-Her2 positive, Her2-enriched, and triple negative) also showed that the chest wall and supraclavicular/infraclavicular nodes were the most common recurrence sites. Age, tumor location, T stage, N stage, and hormone receptor status were independent prognostic factors for both local recurrence and regional recurrence (p < 0.05).
Conclusions: The chest wall and supraclavicular/infraclavicular nodes are common sites of locoregional recurrence in breast cancer, irrespective of disease stage or molecular subtype, and the prognostic factors for local recurrence and regional recurrence are similar. Therefore, chest wall and supraclavicular/infraclavicular nodes irradiation should always be considered in post-mastectomy radiotherapy.
Keywords
Breast neoplasm, Mastectomy, Locoregional Recurrence, Risk Factors
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CURRENT STATUS: Published
Version 2
Posted 01 Jun, 2020
Published
On 04 Sep, 2020
No community comments so far
Editorial decision: Accept
On 05 Aug, 2020
Reviewer #1 agreed
On 13 Jun, 2020
Review #1 received
Received 13 Jun, 2020
Reviewers invited
Invitations sent on 10 Jun, 2020
Editor assigned
On 25 May, 2020
Submission checks complete
On 24 May, 2020
Editor invited
On 24 May, 2020
No comments provided
Editorial decision: Major revision
On 19 May, 2020
Review #2 received
Received 17 May, 2020
Review #1 received
Received 11 May, 2020
Reviewer #2 agreed
On 28 Apr, 2020
Reviewer #1 agreed
On 27 Apr, 2020
Reviewers invited
Invitations sent on 26 Feb, 2020
Editor assigned
On 10 Feb, 2020
First submitted
On 09 Feb, 2020
Submission checks complete
On 09 Feb, 2020
Editor invited
On 09 Feb, 2020
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This preprint is under consideration at Radiation Oncology. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research
Locoregional recurrence patterns in women with breast cancer who have not undergone post-mastectomy radiotherapy
Ye-Xiong Li
Chinese Academy of Medical Sciences and Peking Union Medical College
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
Version 2
Posted 01 Jun, 2020
Published
On 04 Sep, 2020
No community comments so far
Editorial decision: Accept
On 05 Aug, 2020
Reviewer #1 agreed
On 13 Jun, 2020
Review #1 received
Received 13 Jun, 2020
Reviewers invited
Invitations sent on 10 Jun, 2020
Editor assigned
On 25 May, 2020
Submission checks complete
On 24 May, 2020
Editor invited
On 24 May, 2020
No comments provided
Editorial decision: Major revision
On 19 May, 2020
Review #2 received
Received 17 May, 2020
Review #1 received
Received 11 May, 2020
Reviewer #2 agreed
On 28 Apr, 2020
Reviewer #1 agreed
On 27 Apr, 2020
Reviewers invited
Invitations sent on 26 Feb, 2020
Editor assigned
On 10 Feb, 2020
First submitted
On 09 Feb, 2020
Submission checks complete
On 09 Feb, 2020
Editor invited
On 09 Feb, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at Radiation Oncology.
Background : To analyze the patterns of locoregional recurrence in breast cancer patients after mastectomy.
Methods : The retrospective study included 7073 women with breast cancer without post-mastectomy radiotherapy: 4604 (65.1%) had pT1-2N0 disease (low risk); 2042 (28.9%), pT1-2N1 (intermediate risk); and 427 (6.0%), pT3-4 and/or pN2-3, or pT1-2N1 after neoadjuvant chemotherapy (high risk). The distribution of cumulative locoregional recurrence was analyzed. The local recurrence and regional recurrence rates were estimated by the Kaplan-Meier method, and differences were compared with the log-rank test. Multivariate analysis was performed using Cox logistic regression analysis.
Results: In the median follow-up of 63.0 months, 469 patients had locoregional recurrence: chest wall recurrence in 238 cases (50.7%), supraclavicular/infraclavicular nodes in 236 (50.3%) cases, axilla in 92 (19.6%), and internal mammary nodes in 50 (10.7%) cases. The 5-year local recurrence and regional recurrence rates were 2.5% and 4.4%, respectively. Subgroup analysis of the three risk groups and five molecular subtypes (luminal A, luminal B-Her2 negative, luminal B-Her2 positive, Her2-enriched, and triple negative) also showed that the chest wall and supraclavicular/infraclavicular nodes were the most common recurrence sites. Age, tumor location, T stage, N stage, and hormone receptor status were independent prognostic factors for both local recurrence and regional recurrence (p < 0.05).
Conclusions: The chest wall and supraclavicular/infraclavicular nodes are common sites of locoregional recurrence in breast cancer, irrespective of disease stage or molecular subtype, and the prognostic factors for local recurrence and regional recurrence are similar. Therefore, chest wall and supraclavicular/infraclavicular nodes irradiation should always be considered in post-mastectomy radiotherapy.
Figure 1
Figure 2
Figure 3
Figure 4