Post-mastectomy radiotherapy for women with early breast cancer and one to three positive lymph nodes

Verma, Rashmi; Chandarana, Mihir; Barrett, Jessica; Anandadas, C.; Rajan, Sreekumar Sundara

doi:10.1002/14651858.cd014463.pub2

Cited by 5 publications

(1 citation statement)

References 62 publications

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“…Postmastectomy radiotherapy (PMRT) has been shown to decrease local recurrence and improve survival in women with node-positive breast cancer 1 . It reduces the risk of local recurrence and improves overall survival by 24% in woman 2 .…”

Section: Introductionmentioning

confidence: 99%

Microcirculatory changes in the skin after postmastectomy radiotherapy in women with breast cancer

Elawa,

Mirdell,

Stefanis

et al. 2024

Sci Rep

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Postmastectomy radiotherapy (PMRT) increases the risk for complications after breast reconstruction. The pathophysiological mechanism underlying this increased risk is not completely understood. The aim of this study was to examine if there is a relationship between PMRT and microvascular perfusion in the skin directly after, and at 2 and 6 months after PMRT and to assess if there is impaired responsiveness to a topically applied vasodilator (Methyl nicotinate—MN) after PMRT. Skin microvascular responses after PMRT were measured on two sites in the irradiated chest wall of 22 women before, immediately after, and at 2 and 6 months after unilateral PMRT with the contralateral breast as a control. A significant increase in basal skin perfusion was observed in the irradiated chest wall immediately after RT (p < 0.0001). At 2 and 6 months after RT, there was no longer a difference in basal skin perfusion compared to the contralateral breast and compared to baseline. Similarly, the blood flow response in the skin after application of MN was stronger immediately after RT compared to before RT (p < 0.0001), but there was no difference at later time points. These results indicate that the increased risk for complications after surgical procedures are not directly related to changes in skin perfusion and microvascular responsiveness observed after postmastectomy RT.

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Section: Introductionmentioning

confidence: 99%

Microcirculatory changes in the skin after postmastectomy radiotherapy in women with breast cancer

Elawa,

Mirdell,

Stefanis

et al. 2024

Sci Rep

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What are the effects of postmastectomy radiotherapy (PMRT) for women with early breast cancer and one to three positive lymph nodes?

Tort,

Ciapponi

2023

Cochrane Clinical Answers

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De-escalation of Radiation Therapy in the Treatment Plan of Patients with Stage I-IIV Breast Cancer after Subcutaneous/Skin-Sparing Mastectomies with Immediate Reconstruction

Rasskazova,

Zikiryakhodzhaev

2024

Kreativnaâ hirurgiâ i onkologiâ

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Introduction. Indications for radiation therapy after mastectomies with/without reconstruction at T12N01M0 remain unclear; treatment standards contain references to the possible administration of radiation therapy for factors that increase breast cancer recurrence. Materials and methods. A retrospective singlecenter, nonrandomized study enrolled 984 breast cancer patients treated at P.A. Gertsen Moscow Cancer Research Institute from 2014 to 2022. Patients were divided into 2 groups: a radiotherapy group and a nonradiotherapy group. Results and discussion. The paper presents an analysis of patients’ age, the histological structure of the tumor, immunohistochemical characteristics, tumor grade, multicentricity, presence of lymphovascular invasion, tumor cells, the state of R1 and R0 margins, and the tumor stage at risk of recurrence. Overall survival in the recurrence group accounted for 95.1%, in the nonrecurrence group – 98.4%. In the radiotherapy group (group I), the overall survival comprised 98.4%; metastases were diagnosed in 4.9% of cases. In thenonradiotherapy group (group II), the overall survival amounted to 98.2%; metastases were revealed in 5.9% of cases. Conclusion. Univariate analysis in the study groups showed that radiation therapy reduced the risk of relapse by 3.5%. In case of positive R1 margin, radiotherapy is recommended, which was confirmed in our study, the difference accounted for 14.5%, and in the presence of R1, radiotherapy is claimed to be necessary in the postoperative period. When analyzing the stage of breast cancer and the risk of recurrence, the statistical difference was revealed only at stage IIA (T1N1M0); radiation therapy reduced the risk of breast cancer recurrence. The statistical difference in groups I and II was detected at Grade 2 tumor, Ki67 level less than 50%, presence of tumor embolism and age of patients under 40 years. Radiation therapy after subcutaneous/skinsparing mastectomy reduces the recurrence risk by 3.2%; however, the overall survival in group I and group II accounted for 98.4 and 98.2%, respectively; the difference is not statistically significant. In our study, the criteria for prescribing radiation therapy in the postoperative period include: young age of the patients, R1 resection margin, luminal/nonluminal HER2 positive type, cN1, presence of tumor embolism.

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Post-mastectomy radiotherapy for women with early breast cancer and one to three positive lymph nodes

Cited by 5 publications

References 62 publications

Microcirculatory changes in the skin after postmastectomy radiotherapy in women with breast cancer

Microcirculatory changes in the skin after postmastectomy radiotherapy in women with breast cancer

What are the effects of postmastectomy radiotherapy (PMRT) for women with early breast cancer and one to three positive lymph nodes?

De-escalation of Radiation Therapy in the Treatment Plan of Patients with Stage I-IIV Breast Cancer after Subcutaneous/Skin-Sparing Mastectomies with Immediate Reconstruction

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