Is regional lymph node irradiation necessary in stage II to III breast cancer patients with negative pathologic node status after neoadjuvant chemotherapy? 2010

Caroline Daveau, and Denise Stevens, and Etienne Brain, and Oscar Berges, and Sylviane Villette, and Patricia Moisson, and Miriam Gardner, and Brigitte De la Lande, and Serge Lasry, and Alain Labib, and Romuald Le Scodan
Department of Radiation Oncology, Centre René Huguenin, Saint-Cloud, France.

OBJECTIVE Neoadjuvant chemotherapy (NAC) generally induces significant changes in the pathologic extent of disease. This potential down-staging challenges the standard indications of adjuvant radiation therapy. We assessed the utility of lymph node irradiation (LNI) in breast cancer (BC) patients with pathologic N0 status (pN0) after NAC and breast-conserving surgery (BCS). METHODS Among 1,054 BC patients treated with NAC in our institution between 1990 and 2004, 248 patients with clinical N0 or N1 to N2 lymph node status at diagnosis had pN0 status after NAC and BCS. Cox regression analysis was used to identify factors influencing locoregional recurrence-free survival (LRR-FS), disease-free survival (DFS), and overall survival (OS). RESULTS All 248 patients underwent breast irradiation, and 158 patients (63.7%) also received LNI. With a median follow-up of 88 months, the 5-year LRR-FS and OS rates were respectively 89.4% and 88.7% with LNI and 86.2% and 92% without LNI (no significant difference). Survival was poorer among patients who did not have a pathologic complete primary tumor response (hazard ratio, 3.05; 95% confidence interval, 1.17-7.99) and in patients with N1 to N2 clinical status at diagnosis (hazard ratio = 2.24; 95% confidence interval, 1.15-4.36). LNI did not significantly affect survival. CONCLUSIONS Relative to combined breast and local lymph node irradiation, isolated breast irradiation does not appear to be associated with a higher risk of locoregional relapse or death among cN0 to cN2 breast cancer patients with pN0 status after NAC. These results need to be confirmed in a prospective study.

UI MeSH Term Description Entries
D008197 Lymph Node Excision Surgical excision of one or more lymph nodes. Its most common use is in cancer surgery. (From Dorland, 28th ed, p966) Lymph Node Dissection,Lymphadenectomy,Dissection, Lymph Node,Dissections, Lymph Node,Excision, Lymph Node,Excisions, Lymph Node,Lymph Node Dissections,Lymph Node Excisions,Lymphadenectomies,Node Dissection, Lymph,Node Dissections, Lymph
D008198 Lymph Nodes They are oval or bean shaped bodies (1 - 30 mm in diameter) located along the lymphatic system. Lymph Node,Node, Lymph,Nodes, Lymph
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009364 Neoplasm Recurrence, Local The local recurrence of a neoplasm following treatment. It arises from microscopic cells of the original neoplasm that have escaped therapeutic intervention and later become clinically visible at the original site. Local Neoplasm Recurrence,Local Neoplasm Recurrences,Locoregional Neoplasm Recurrence,Neoplasm Recurrence, Locoregional,Neoplasm Recurrences, Local,Recurrence, Local Neoplasm,Recurrence, Locoregional Neoplasm,Recurrences, Local Neoplasm,Locoregional Neoplasm Recurrences,Neoplasm Recurrences, Locoregional,Recurrences, Locoregional Neoplasm
D009367 Neoplasm Staging Methods which attempt to express in replicable terms the extent of the neoplasm in the patient. Cancer Staging,Staging, Neoplasm,Tumor Staging,TNM Classification,TNM Staging,TNM Staging System,Classification, TNM,Classifications, TNM,Staging System, TNM,Staging Systems, TNM,Staging, Cancer,Staging, TNM,Staging, Tumor,System, TNM Staging,Systems, TNM Staging,TNM Classifications,TNM Staging Systems
D011879 Radiotherapy Dosage The total amount of radiation absorbed by tissues as a result of radiotherapy. Dosage, Radiotherapy,Dosages, Radiotherapy,Radiotherapy Dosages
D012044 Regression Analysis Procedures for finding the mathematical function which best describes the relationship between a dependent variable and one or more independent variables. In linear regression (see LINEAR MODELS) the relationship is constrained to be a straight line and LEAST-SQUARES ANALYSIS is used to determine the best fit. In logistic regression (see LOGISTIC MODELS) the dependent variable is qualitative rather than continuously variable and LIKELIHOOD FUNCTIONS are used to find the best relationship. In multiple regression, the dependent variable is considered to depend on more than a single independent variable. Regression Diagnostics,Statistical Regression,Analysis, Regression,Analyses, Regression,Diagnostics, Regression,Regression Analyses,Regression, Statistical,Regressions, Statistical,Statistical Regressions
D001943 Breast Neoplasms Tumors or cancer of the human BREAST. Breast Cancer,Breast Tumors,Cancer of Breast,Breast Carcinoma,Cancer of the Breast,Human Mammary Carcinoma,Malignant Neoplasm of Breast,Malignant Tumor of Breast,Mammary Cancer,Mammary Carcinoma, Human,Mammary Neoplasm, Human,Mammary Neoplasms, Human,Neoplasms, Breast,Tumors, Breast,Breast Carcinomas,Breast Malignant Neoplasm,Breast Malignant Neoplasms,Breast Malignant Tumor,Breast Malignant Tumors,Breast Neoplasm,Breast Tumor,Cancer, Breast,Cancer, Mammary,Cancers, Mammary,Carcinoma, Breast,Carcinoma, Human Mammary,Carcinomas, Breast,Carcinomas, Human Mammary,Human Mammary Carcinomas,Human Mammary Neoplasm,Human Mammary Neoplasms,Mammary Cancers,Mammary Carcinomas, Human,Neoplasm, Breast,Neoplasm, Human Mammary,Neoplasms, Human Mammary,Tumor, Breast
D005260 Female Females
D005500 Follow-Up Studies Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease. Followup Studies,Follow Up Studies,Follow-Up Study,Followup Study,Studies, Follow-Up,Studies, Followup,Study, Follow-Up,Study, Followup

Related Publications

Caroline Daveau, and Denise Stevens, and Etienne Brain, and Oscar Berges, and Sylviane Villette, and Patricia Moisson, and Miriam Gardner, and Brigitte De la Lande, and Serge Lasry, and Alain Labib, and Romuald Le Scodan
February 2022, Clinical breast cancer,
Caroline Daveau, and Denise Stevens, and Etienne Brain, and Oscar Berges, and Sylviane Villette, and Patricia Moisson, and Miriam Gardner, and Brigitte De la Lande, and Serge Lasry, and Alain Labib, and Romuald Le Scodan
April 1992, Journal of surgical oncology,
Caroline Daveau, and Denise Stevens, and Etienne Brain, and Oscar Berges, and Sylviane Villette, and Patricia Moisson, and Miriam Gardner, and Brigitte De la Lande, and Serge Lasry, and Alain Labib, and Romuald Le Scodan
April 2022, Clinical breast cancer,
Caroline Daveau, and Denise Stevens, and Etienne Brain, and Oscar Berges, and Sylviane Villette, and Patricia Moisson, and Miriam Gardner, and Brigitte De la Lande, and Serge Lasry, and Alain Labib, and Romuald Le Scodan
November 2020, International journal of radiation oncology, biology, physics,
Caroline Daveau, and Denise Stevens, and Etienne Brain, and Oscar Berges, and Sylviane Villette, and Patricia Moisson, and Miriam Gardner, and Brigitte De la Lande, and Serge Lasry, and Alain Labib, and Romuald Le Scodan
September 2022, Cancers,
Caroline Daveau, and Denise Stevens, and Etienne Brain, and Oscar Berges, and Sylviane Villette, and Patricia Moisson, and Miriam Gardner, and Brigitte De la Lande, and Serge Lasry, and Alain Labib, and Romuald Le Scodan
June 2021, The British journal of surgery,
Caroline Daveau, and Denise Stevens, and Etienne Brain, and Oscar Berges, and Sylviane Villette, and Patricia Moisson, and Miriam Gardner, and Brigitte De la Lande, and Serge Lasry, and Alain Labib, and Romuald Le Scodan
June 2011, European journal of nuclear medicine and molecular imaging,
Caroline Daveau, and Denise Stevens, and Etienne Brain, and Oscar Berges, and Sylviane Villette, and Patricia Moisson, and Miriam Gardner, and Brigitte De la Lande, and Serge Lasry, and Alain Labib, and Romuald Le Scodan
March 2019, Annals of the Royal College of Surgeons of England,
Caroline Daveau, and Denise Stevens, and Etienne Brain, and Oscar Berges, and Sylviane Villette, and Patricia Moisson, and Miriam Gardner, and Brigitte De la Lande, and Serge Lasry, and Alain Labib, and Romuald Le Scodan
May 2008, Annals of surgical oncology,
Caroline Daveau, and Denise Stevens, and Etienne Brain, and Oscar Berges, and Sylviane Villette, and Patricia Moisson, and Miriam Gardner, and Brigitte De la Lande, and Serge Lasry, and Alain Labib, and Romuald Le Scodan
April 2020, Medical science monitor : international medical journal of experimental and clinical research,
Copied contents to your clipboard!