Post-mastectomy radiation therapy in breast cancer patients with 1-3 positive lymph nodes : no one size fits all

Kayali, Majd; Jaoude, Joseph Abi; Tfayli, Arafat; El Saghir, Nagi; Poortmans, Philip; Zeidan, Youssef H.

doi:10.1016/J.CRITREVONC.2020.102880

Title

Post-mastectomy radiation therapy in breast cancer patients with 1-3 positive lymph nodes : no one size fits all

Author

Kayali, Majd

Jaoude, Joseph Abi

Tfayli, Arafat

El Saghir, Nagi

Poortmans, Philip

Zeidan, Youssef H.

Abstract

Post-mastectomy radiation therapy (PMRT) is standard therapy for advanced breast cancer. However, given the lower risk of recurrence, PMRT administration remains controversial in select patients with limited nodal disease. We performed a review of the literature that focuses on the effect of PMRT in breast cancer patients with 1-3 positive lymph nodes, mainly examining loco-regional recurrence (LRR) and overall survival (OS). Most studies, including a large meta-analysis by the EBCTCG, showed a significant improvement in LRR rates among patients receiving PMRT. While most studies demonstrated a trend towards OS improvement, only few studies showed a statistically significant OS or breast cancer-specific survival benefit for PMRT. As such, individualized treatment decisions are recommended, taking into consideration clinicopathological findings. Future studies with large sample sizes and long follow-up times are still needed to better assess the role of PMRT in patients with limited nodal involvement.

Language

English

Source (journal)

Critical reviews in oncology, hematology / Chemical Rubber Company [Cleveland, Ohio] - Boca Raton, Fla

Publication

New york : Elsevier science inc , 2020

ISSN

1040-8428

DOI

10.1016/J.CRITREVONC.2020.102880

Volume/pages

147 (2020) , 6 p.