Locoregional Recurrence Risk in Breast Cancer Patients with Estrogen Receptor Positive Tumors and Residual Nodal Disease following Neoadjuvant Chemotherapy and Mastectomy without Radiation Therapy
Among breast cancer patients treated with neoadjuvant chemotherapy (NAC) and mastectomy, locoregional recurrence (LRR) rates are unclear in women with ER+ tumors treated with adjuvant endocrine therapy without postmastectomy radiation (PMRT). To determine if PMRT is needed in these patients, we comp...
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| Format: | Article |
| Language: | English |
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Wiley
2015-01-01
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| Series: | International Journal of Breast Cancer |
| Online Access: | http://dx.doi.org/10.1155/2015/147476 |
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| author | Shravan Kandula Jeffrey M. Switchenko Saul Harari Carolina Fasola Donna Mister David S. Yu Amelia B. Zelnak Mylin A. Torres |
| author_facet | Shravan Kandula Jeffrey M. Switchenko Saul Harari Carolina Fasola Donna Mister David S. Yu Amelia B. Zelnak Mylin A. Torres |
| author_sort | Shravan Kandula |
| collection | DOAJ |
| description | Among breast cancer patients treated with neoadjuvant chemotherapy (NAC) and mastectomy, locoregional recurrence (LRR) rates are unclear in women with ER+ tumors treated with adjuvant endocrine therapy without postmastectomy radiation (PMRT). To determine if PMRT is needed in these patients, we compared LRR rates of patients with ER+ tumors (treated with adjuvant endocrine therapy) with women who have non-ER+ tumors. 85 consecutive breast cancer patients (87 breast tumors) treated with NAC and mastectomy without PMRT were reviewed. Patients were divided by residual nodal disease (ypN) status (ypN+ versus ypN0) and then stratified by receptor subtype. Among ypN+ patients (n=35), five-year LRR risk in patients with ER+, Her2+, and triple negative tumors was 5%, 33%, and 37%, respectively (p=0.02). Among ypN+/ER+ patients, lymphovascular invasion and grade three disease increased the five-year LRR risk to 13% and 11%, respectively. Among ypN0 patients (n=52), five-year LRR risk in patients with ER+, Her2+, and triple negative tumors was 7%, 22%, and 6%, respectively (p=0.71). In women with ER+ tumors and residual nodal disease, endocrine therapy may be sufficient adjuvant treatment, except in patients with lymphovascular invasion or grade three tumors where PMRT may still be indicated. |
| format | Article |
| id | doaj-art-3c59f659c91c4c4d94ded16d72437353 |
| institution | OA Journals |
| issn | 2090-3170 2090-3189 |
| language | English |
| publishDate | 2015-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | International Journal of Breast Cancer |
| spelling | doaj-art-3c59f659c91c4c4d94ded16d724373532025-08-20T02:08:19ZengWileyInternational Journal of Breast Cancer2090-31702090-31892015-01-01201510.1155/2015/147476147476Locoregional Recurrence Risk in Breast Cancer Patients with Estrogen Receptor Positive Tumors and Residual Nodal Disease following Neoadjuvant Chemotherapy and Mastectomy without Radiation TherapyShravan Kandula0Jeffrey M. Switchenko1Saul Harari2Carolina Fasola3Donna Mister4David S. Yu5Amelia B. Zelnak6Mylin A. Torres7Department of Radiation Oncology, Emory University School of Medicine, Atlanta, GA 30322, USADepartment of Biostatistics and Bioinformatics, Emory University, Atlanta, GA 30322, USADepartment of Pathology, Emory University, Atlanta, GA 30322, USADepartment of Radiation Oncology, Stanford Medical Center, Stanford, CA 94305, USADepartment of Radiation Oncology, Emory University School of Medicine, Atlanta, GA 30322, USADepartment of Radiation Oncology, Emory University School of Medicine, Atlanta, GA 30322, USAWinship Cancer Institute, Emory University, Atlanta, GA 30322, USADepartment of Radiation Oncology, Emory University School of Medicine, Atlanta, GA 30322, USAAmong breast cancer patients treated with neoadjuvant chemotherapy (NAC) and mastectomy, locoregional recurrence (LRR) rates are unclear in women with ER+ tumors treated with adjuvant endocrine therapy without postmastectomy radiation (PMRT). To determine if PMRT is needed in these patients, we compared LRR rates of patients with ER+ tumors (treated with adjuvant endocrine therapy) with women who have non-ER+ tumors. 85 consecutive breast cancer patients (87 breast tumors) treated with NAC and mastectomy without PMRT were reviewed. Patients were divided by residual nodal disease (ypN) status (ypN+ versus ypN0) and then stratified by receptor subtype. Among ypN+ patients (n=35), five-year LRR risk in patients with ER+, Her2+, and triple negative tumors was 5%, 33%, and 37%, respectively (p=0.02). Among ypN+/ER+ patients, lymphovascular invasion and grade three disease increased the five-year LRR risk to 13% and 11%, respectively. Among ypN0 patients (n=52), five-year LRR risk in patients with ER+, Her2+, and triple negative tumors was 7%, 22%, and 6%, respectively (p=0.71). In women with ER+ tumors and residual nodal disease, endocrine therapy may be sufficient adjuvant treatment, except in patients with lymphovascular invasion or grade three tumors where PMRT may still be indicated.http://dx.doi.org/10.1155/2015/147476 |
| spellingShingle | Shravan Kandula Jeffrey M. Switchenko Saul Harari Carolina Fasola Donna Mister David S. Yu Amelia B. Zelnak Mylin A. Torres Locoregional Recurrence Risk in Breast Cancer Patients with Estrogen Receptor Positive Tumors and Residual Nodal Disease following Neoadjuvant Chemotherapy and Mastectomy without Radiation Therapy International Journal of Breast Cancer |
| title | Locoregional Recurrence Risk in Breast Cancer Patients with Estrogen Receptor Positive Tumors and Residual Nodal Disease following Neoadjuvant Chemotherapy and Mastectomy without Radiation Therapy |
| title_full | Locoregional Recurrence Risk in Breast Cancer Patients with Estrogen Receptor Positive Tumors and Residual Nodal Disease following Neoadjuvant Chemotherapy and Mastectomy without Radiation Therapy |
| title_fullStr | Locoregional Recurrence Risk in Breast Cancer Patients with Estrogen Receptor Positive Tumors and Residual Nodal Disease following Neoadjuvant Chemotherapy and Mastectomy without Radiation Therapy |
| title_full_unstemmed | Locoregional Recurrence Risk in Breast Cancer Patients with Estrogen Receptor Positive Tumors and Residual Nodal Disease following Neoadjuvant Chemotherapy and Mastectomy without Radiation Therapy |
| title_short | Locoregional Recurrence Risk in Breast Cancer Patients with Estrogen Receptor Positive Tumors and Residual Nodal Disease following Neoadjuvant Chemotherapy and Mastectomy without Radiation Therapy |
| title_sort | locoregional recurrence risk in breast cancer patients with estrogen receptor positive tumors and residual nodal disease following neoadjuvant chemotherapy and mastectomy without radiation therapy |
| url | http://dx.doi.org/10.1155/2015/147476 |
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