Post-operative radiation in early breast cancer with N1 disease: 10-year follow-up

Post-operative radiotherapy for post-menopausal women with early breast cancer and N1 disease is controversial. Although locoregional control is improved, overall survival (OS) benefit is unclear. The clinical benefit of post-operative irradiation in this group of patients over 10 years was reviewed...

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Main Authors: Tang, Serene Ee Ling, Sim, E-Jan, Ang, Wei-Wen, Su, Jun, Chen, Juliana Jia Chuan, Chan, Patrick Mun Yew, Choo, Bok Ai, Tan, Ern Yu
Other Authors: Lee Kong Chian School of Medicine (LKCMedicine)
Format: Article
Language:English
Published: 2024
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Online Access:https://hdl.handle.net/10356/181717
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Institution: Nanyang Technological University
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spelling sg-ntu-dr.10356-1817172024-12-16T01:37:39Z Post-operative radiation in early breast cancer with N1 disease: 10-year follow-up Tang, Serene Ee Ling Sim, E-Jan Ang, Wei-Wen Su, Jun Chen, Juliana Jia Chuan Chan, Patrick Mun Yew Choo, Bok Ai Tan, Ern Yu Lee Kong Chian School of Medicine (LKCMedicine) Tan Tock Seng Hospital Institute of Molecular and Cell Biology, A*STAR Medicine, Health and Life Sciences Nodal radiation Recurrence Post-operative radiotherapy for post-menopausal women with early breast cancer and N1 disease is controversial. Although locoregional control is improved, overall survival (OS) benefit is unclear. The clinical benefit of post-operative irradiation in this group of patients over 10 years was reviewed. We aimed to evaluate the OS, disease-free survival (DFS), and factors affecting OS and DFS. A retrospective review of 191 post-menopausal women with early breast cancer and N1 disease from 2004 to 2011 was performed. Demographics, post-operative histology, adjuvant treatment, OS, and DFS were evaluated. Post-operative radiation was given to 95 of 191 women (49.7%). Younger age at diagnosis (p < 0.001), a greater number of involved nodes (p = 0.004), lymphovascular invasion (LVI), and a higher tumor grade (p = 0.001) were more likely in women who received post-operative radiation. Nodal radiation did not improve 10-year DFS (p = 0.084) or OS (p = 0.203). Post-operative nodal radiation was associated with significant improvement in 10-year OS in women who received only hormonal therapy (p = 0.047) and no other systemic therapy. Women with unfavorable risk factors were more likely to receive post-operative radiation, likely due to a perceived higher risk of recurrence. Nodal radiation did not significantly improve 10-year DFS or OS in early breast cancer patients with N1 disease, and the benefit was not clearly demonstrated. However, in those who were on hormonal therapy, radiotherapy was beneficial in improving overall survival. Published version 2024-12-16T01:37:39Z 2024-12-16T01:37:39Z 2024 Journal Article Tang, S. E. L., Sim, E., Ang, W., Su, J., Chen, J. J. C., Chan, P. M. Y., Choo, B. A. & Tan, E. Y. (2024). Post-operative radiation in early breast cancer with N1 disease: 10-year follow-up. Diseases, 12(7), 145-. https://dx.doi.org/10.3390/diseases12070145 2079-9721 https://hdl.handle.net/10356/181717 10.3390/diseases12070145 39057116 2-s2.0-85199534630 7 12 145 en Diseases © 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https:// creativecommons.org/licenses/by/ 4.0/). application/pdf
institution Nanyang Technological University
building NTU Library
continent Asia
country Singapore
Singapore
content_provider NTU Library
collection DR-NTU
language English
topic Medicine, Health and Life Sciences
Nodal radiation
Recurrence
spellingShingle Medicine, Health and Life Sciences
Nodal radiation
Recurrence
Tang, Serene Ee Ling
Sim, E-Jan
Ang, Wei-Wen
Su, Jun
Chen, Juliana Jia Chuan
Chan, Patrick Mun Yew
Choo, Bok Ai
Tan, Ern Yu
Post-operative radiation in early breast cancer with N1 disease: 10-year follow-up
description Post-operative radiotherapy for post-menopausal women with early breast cancer and N1 disease is controversial. Although locoregional control is improved, overall survival (OS) benefit is unclear. The clinical benefit of post-operative irradiation in this group of patients over 10 years was reviewed. We aimed to evaluate the OS, disease-free survival (DFS), and factors affecting OS and DFS. A retrospective review of 191 post-menopausal women with early breast cancer and N1 disease from 2004 to 2011 was performed. Demographics, post-operative histology, adjuvant treatment, OS, and DFS were evaluated. Post-operative radiation was given to 95 of 191 women (49.7%). Younger age at diagnosis (p < 0.001), a greater number of involved nodes (p = 0.004), lymphovascular invasion (LVI), and a higher tumor grade (p = 0.001) were more likely in women who received post-operative radiation. Nodal radiation did not improve 10-year DFS (p = 0.084) or OS (p = 0.203). Post-operative nodal radiation was associated with significant improvement in 10-year OS in women who received only hormonal therapy (p = 0.047) and no other systemic therapy. Women with unfavorable risk factors were more likely to receive post-operative radiation, likely due to a perceived higher risk of recurrence. Nodal radiation did not significantly improve 10-year DFS or OS in early breast cancer patients with N1 disease, and the benefit was not clearly demonstrated. However, in those who were on hormonal therapy, radiotherapy was beneficial in improving overall survival.
author2 Lee Kong Chian School of Medicine (LKCMedicine)
author_facet Lee Kong Chian School of Medicine (LKCMedicine)
Tang, Serene Ee Ling
Sim, E-Jan
Ang, Wei-Wen
Su, Jun
Chen, Juliana Jia Chuan
Chan, Patrick Mun Yew
Choo, Bok Ai
Tan, Ern Yu
format Article
author Tang, Serene Ee Ling
Sim, E-Jan
Ang, Wei-Wen
Su, Jun
Chen, Juliana Jia Chuan
Chan, Patrick Mun Yew
Choo, Bok Ai
Tan, Ern Yu
author_sort Tang, Serene Ee Ling
title Post-operative radiation in early breast cancer with N1 disease: 10-year follow-up
title_short Post-operative radiation in early breast cancer with N1 disease: 10-year follow-up
title_full Post-operative radiation in early breast cancer with N1 disease: 10-year follow-up
title_fullStr Post-operative radiation in early breast cancer with N1 disease: 10-year follow-up
title_full_unstemmed Post-operative radiation in early breast cancer with N1 disease: 10-year follow-up
title_sort post-operative radiation in early breast cancer with n1 disease: 10-year follow-up
publishDate 2024
url https://hdl.handle.net/10356/181717
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