Mastectomy alone for pT1-2 pN0-1 breast cancer patients: when postmastectomy radiotherapy is indicated.

摘要: To assess outcome of breast cancer (BC) stages pT1-2 N0-1 after mastectomy alone and to identify prognostic factors calling for the need postmastectomy radiotherapy. Patients who were not eligible conserving surgery (BCS) operated on with between 1998 2008. Locoregional (LRR), distant (DM) control specific survival (BCSS) retrospectively evaluated. Cumulative incidence (CI) events was estimated according Kalbfleisch Prentice while Gray’s test tested difference. Kaplan–Meier method Cox proportional hazards model univariable multivariable analysis used. A matched pair BCS plus whole irradiation (WBI), using propensity score method, performed. 1281 N0 1081 N1 identified. Median follow-up 8.2 years (9.2 years survival). Overall, LRR rate low both subgroups (10-year CI, 8.8% 10.9%, respectively). Young age, lymphovascular invasion Ki-67 ≥ 20% proved be statistically significant at analysis. The combination of ≥ 2 risk increased to ≥ 15%. Risk weighed more than nodal status itself. DM doubled moving from negative positive CI 10.5% versus 20.3%, BCSS remained high in 92.4% 84.5%, Remarkably, all molecular subtypes except Luminal significantly affected subgroups. Nodes number impacted but locoregional control. In analysis, WBI decreased recurrence improved control, without affecting survival. Selected patients, namely those least two additional factors, presented enough support use radiotherapy Moreover, observation that may provide benefits go beyond local deserves further investigated.