Published in:
01-12-2018 | ASO Author Reflections
ASO Author Reflections: Locoregional Recurrence Rates are Low with the Selective Use of PMRT in Patients with T1-2 Tumors and One to Three Positive Lymph Nodes
Authors:
Tracy-Ann Moo, MD, Mahmoud El-Tamer, MD
Published in:
Annals of Surgical Oncology
|
Special Issue 3/2018
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Excerpt
In the 1990s three landmark randomized controlled trials were published that demonstrated a decrease in local regional recurrence (LRR) and improved survival in patients with node-positive breast cancer who received postmastectomy radiation (PMRT).
1,
2 These data, along with subsequent meta-analyses, formed the basis of guidelines that endorsed the use of PMRT in patients with tumors > 5 cm and/or four or more positive lymph nodes. In the group of patients with T1-2 tumors and one to three positive lymph nodes, meta-analyses showed a similar LRR and survival benefit among those patients who received PMRT.
3 Criticisms of these data surround the high rates of LRR that were observed in these early trials, i.e., 20–25%, much higher than those reported in more contemporary studies of approximately 12%. This discrepancy makes it problematic to extrapolate results from these trials to patients treated in the current era of multimodal therapy, particularly in the group of patients with limited disease burden who are at a lower risk of LRR. …
