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Title: Regional recurrence in breast cancer patients with one to three positive axillary lymph nodes treated with breast-conserving surgery and whole breast irradiation
Authors: Hirata, Kimiko
Yoshimura, Michio  kyouindb  KAKEN_id
Inoue, Minoru  kyouindb  KAKEN_id  orcid (unconfirmed)
Yamauchi, Chikako
Ogura, Masakazu
Toi, Masakazu  kyouindb  KAKEN_id
Suzuki, Eiji
Takeuchi, Megumi
Takada, Masahiro
Hiraoka, Masahiro
Author's alias: 平田, 希美子
吉村, 通央
戸井, 雅和
鈴木, 栄治
竹内, 恵
髙田, 正泰
Keywords: radiotherapy
breast cancer
breast-conserving therapy
Issue Date: 23-Jan-2017
Publisher: Oxford University Press (OUP)
Journal title: Journal of radiation research
Volume: 58
Issue: 1
Start page: 79
End page: 85
Abstract: Radiotherapy with breast-conserving therapy plays a crucial role in the treatment of early breast cancer. However, optimal radiotherapy targets have been controversial. We therefore evaluated regional recurrence in breast cancer patients with one to three positive lymph nodes (LNs) treated with breast-conserving surgery (BCS) followed by whole-breast irradiation (WBI). From 1993 to 2010, 121 breast cancer patients with one to three positive LNs who underwent BCS followed by WBI were analyzed. All patients underwent radiotherapy with two tangential fields to the whole breast. To evaluate the radiation dose to the axillary LNs, we contoured axillary LNs area and evaluated the dose–volumetric parameters. The median follow-up time was 112.4 months (range, 15.6–248.1 months). The 5-year overall survival and disease-free survival rates were 95.6% and 86.6%, respectively. The 5-year regional recurrence–free rate (RRFR) was 97.4%. During follow-up, six patients had regional recurrence. The pathological T stage was the factor best associated with the 5-year RRFR using the log-rank test, with 100.0% in the pT1 cohort versus 94.7% in the pT2–4 cohort (P < 0.01). The radiation dose to the axillary LNs did not contribute to the RRFR. In conclusion, while the pathological T stage was the prognostic factor best associated with regional recurrence, few regional recurrences were observed in early breast cancer patients with one to three LNs treated with BCS followed by WBI. Unintentional radiation doses to the axillary LNs using standard WBI were not related to the RRFR after axillary dissection.
Rights: © The Author 2016. Published by Oxford University Press on behalf of The Japan Radiation Research Society and Japanese Society for Radiation Oncology.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (, which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
DOI(Published Version): 10.1093/jrr/rrw071
PubMed ID: 27422931
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