open access

Vol 24, No 1 (2019)
Original research articles
Published online: 2019-01-01
Submitted: 2018-06-29
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Patterns of post-operative irradiation in breast cancer patients submitted to neoadjuvant chemotherapy

Kennya Medeiros Lima, Allan A. Pereira, Thiago B. de Freitas, Saulo Brito Silva, Heloisa de Carvalho, Max S. Mano, Gustavo Nader Marta
DOI: 10.1016/j.rpor.2018.11.002
·
Rep Pract Oncol Radiother 2019;24(1):115-123.

open access

Vol 24, No 1 (2019)
Original research articles
Published online: 2019-01-01
Submitted: 2018-06-29

Abstract

Background/Aim

Post-operative radiation therapy (PORT) is associated with improvement in loco-regional control and survival rates in early breast cancer. However, the evidence of benefit in patients after treatment with neoadjuvant chemotherapy (NAC) is poor. We aimed to assess the impact of the type of surgery in the PORT plan and the role of the PORT fields in clinical outcomes in breast cancer patients who had undergone NAC followed by surgery.

Materials and methods

We performed a retrospective analysis of all non-metastatic breast cancer patients treated between 2008 and 2014 at our institution who had received NAC and PORT.

Results

A total of 528 women were included of whom 396 were submitted to mastectomy or nipple-sparing/skin-sparing mastectomy. Most (92.8%) of the patients had locally advanced disease (clinical stage IIB to IIIC). All patients underwent irradiation for breast or chest wall. Most patients received PORT to the supraclavicular and axillary (levels II and III) nodes (87.1% and 86.4% for breast-conserving surgery and 95.1% and 93.8% for mastectomy and nipple-sparing/skin-sparing mastectomy, respectively). Irradiation of level I axillary and internal mammary nodes was uncommon. The disease-free survival and overall survival rates at 3 years were 72% and 85%, respectively. There were no statistically significant differences in clinical outcomes according to the use of nodal irradiation.

Conclusions

After NAC, most patients received irradiation of the breast/chest wall and axillary and supraclavicular nodes. In this setting, PORT to breast/chest wall with or without regional nodal irradiation was safe and effective, with acceptable disease-free and overall survival rates reported in this high-risk population.

Abstract

Background/Aim

Post-operative radiation therapy (PORT) is associated with improvement in loco-regional control and survival rates in early breast cancer. However, the evidence of benefit in patients after treatment with neoadjuvant chemotherapy (NAC) is poor. We aimed to assess the impact of the type of surgery in the PORT plan and the role of the PORT fields in clinical outcomes in breast cancer patients who had undergone NAC followed by surgery.

Materials and methods

We performed a retrospective analysis of all non-metastatic breast cancer patients treated between 2008 and 2014 at our institution who had received NAC and PORT.

Results

A total of 528 women were included of whom 396 were submitted to mastectomy or nipple-sparing/skin-sparing mastectomy. Most (92.8%) of the patients had locally advanced disease (clinical stage IIB to IIIC). All patients underwent irradiation for breast or chest wall. Most patients received PORT to the supraclavicular and axillary (levels II and III) nodes (87.1% and 86.4% for breast-conserving surgery and 95.1% and 93.8% for mastectomy and nipple-sparing/skin-sparing mastectomy, respectively). Irradiation of level I axillary and internal mammary nodes was uncommon. The disease-free survival and overall survival rates at 3 years were 72% and 85%, respectively. There were no statistically significant differences in clinical outcomes according to the use of nodal irradiation.

Conclusions

After NAC, most patients received irradiation of the breast/chest wall and axillary and supraclavicular nodes. In this setting, PORT to breast/chest wall with or without regional nodal irradiation was safe and effective, with acceptable disease-free and overall survival rates reported in this high-risk population.

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Keywords

Breast cancer; Neoadjuvant chemotherapy; Radiation therapy; Survival; Recurrence

About this article
Title

Patterns of post-operative irradiation in breast cancer patients submitted to neoadjuvant chemotherapy

Journal

Reports of Practical Oncology and Radiotherapy

Issue

Vol 24, No 1 (2019)

Pages

115-123

Published online

2019-01-01

DOI

10.1016/j.rpor.2018.11.002

Bibliographic record

Rep Pract Oncol Radiother 2019;24(1):115-123.

Keywords

Breast cancer
Neoadjuvant chemotherapy
Radiation therapy
Survival
Recurrence

Authors

Kennya Medeiros Lima
Allan A. Pereira
Thiago B. de Freitas
Saulo Brito Silva
Heloisa de Carvalho
Max S. Mano
Gustavo Nader Marta

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