Author(s): MOHAMMED A OSMAN1, MOHAMMAD S ELKADY2, KHALID E NASR3
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.