gynecology and obstetrics medical project, gynecology journal, obstetrics, gynecologic oncology, reproductive medicine, gynecological endoscopy, ultrasonography, gynecology articles

Ginekologia i Poloznictwo
ISSN 1896-3315 e-ISSN 1898-0759

Stage II node positive breast cancer, is it worth while to consider adjuvant radiotherapy following mastectomy



Introduction. Breast cancer is the most frequent malignant tumor in women worldwide. In Egypt,it is the most common cancer among women, representing 18,9% of total cancer cases. TheAim: To evaluate overall survival (OS), progression free survival (PFS), loco-regional recur-rence (LRR), and toxicities for patients with early breast cancer patients with 1-3positive axillarylymph nodes, with either adjuvant radiotherapy following chemotherapy or only adjuvantchemotherapy.Material and methods. Patients were eligible for enrolment into the study if they had patholo-gically proven stages II breast cancer (T1N1,T0N1,T2N1), with 1-3 positive axillary lymph nodes.Patient should be between 17 and 65 years. Performance state had to be from 0 to 2. Patientswere assigned to one of two groups; Group 1; adjuvant chemotherapy then radiotherapy, andgroup 2; adjuvant chemotherapy only. Radiotherapy was given by 3D conformal radiotherapy.Results.Between September 2008 and August 2014, 75 patients were enrolled in 2 institutesin Egypt. 40 patients were assigned to group1, and 35 to group 2.All patients had stage IIbreast cancer (4T0N1, 29T1N1, 42T2N1). The 4 year OS for group1, and2 were 77.5%, and71.4% respectively. The 4 year PFS for group1 and2 were 72.5%, 60% respectively.Duringthe 54 months follow-up period, 11patients from group1 had breast cancer recurrence (3lo-coregional, 7metastatic, and 1both), and 14 patients from group2 had recurrence (7locoregio-nal, 3metastatic, and 4both). The distant metastasis rate was the same in the 2 groups. Ho-wever, the highest site of metastasis was different between the 2 groups. Treatment protocolwas tolerated well with mild toxicity profile.Conclusion. The addition of radiotherapy to adjuvant chemotherapy in stage II breast cancerwith 1-3 positive lymph nodes improved the PFS, and locoregional recurrence. Radiotherapyimproved OS in patients with high risk features.