Axillary radiotherapy in conservative surgery for early-stage breast cancer (stage I and II).

Abstract:

INTRODUCTION:Several clinical studies analyze axillary treatment in women with early-stage breast cancer because of changes in the indication for axillary lymph node dissection. The aim of the study is to analyze the impact of axillary radiotherapy in disease-free and overall survival in women with early breast cancer treated with lumpectomy. METHODS:Retrospective study in women with initial stages of breast carcinoma treated by lumpectomy. A comparative analysis of high-risk women with axillary lymph node involvement who received axillary radiotherapy with the group of women with low risk without radiotherapy was performed. Logistic regression was used to determine factors influencing survival and lymphedema onset. RESULTS:A total of 541 women were included in the study: 384 patients (71%) without axillary lymph node involvement and 157 women (29%) with 1-3 axillary lymph node involvement. Patients with axillary radiotherapy had a higher number of metastatic lymph node compared to non-irradiated (1.6±0.7 vs. 1.4±0.6, P=.02). The group of women with axillary lymph node involvement and radiotherapy showed an overall and disease-free survival at 10 years similar to that obtained in patients without irradiation (89.7% and 77.2%, respectively). 3 lymph nodes involved multiplied by more than 7 times the risk of death (HR=7.20; 95% CI: 1.36 to 38.12). The multivariate analysis showed axillary lymph node dissection as the only variable associated with the development of lymphedema. CONCLUSION:The incidence of axillary relapse on stage I and II breast cancer is rare. In these patients axillary radiotherapy does not improve overall survival, but contributes to regional control in those patients with risk factors.

journal_name

Cir Esp

journal_title

Cirugia espanola

authors

García Novoa A,Acea Nebril B,Díaz I,Builes Ramírez S,Varela C,Cereijo C,Mosquera Oses J,López Calviño B,Seoane Pillado MT

doi

10.1016/j.ciresp.2016.04.003

subject

Has Abstract

pub_date

2016-06-01 00:00:00

pages

331-8

issue

6

eissn

0009-739X

issn

1578-147X

pii

S0009-739X(16)30038-0

journal_volume

94

pub_type

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