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Prognostic factors for breast cancer patients with T1–2 tumors and 1–3 positive lymph nodes and the role of postmastectomy radiotherapy in these patients

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Abstract

Purpose

The purpose of this study was to identify independent prognostic factors for breast cancer patients with T1–2 tumors and 1–3 positive lymph nodes, and discuss the role of postmastectomy radiotherapy(PMRT) in these patients.

Methods

Between January 2005 and December 2015, the data on 840 eligible patients with breast cancer were retrospectively reviewed. Of these patients, 368 women received PMRT and 472 did not. The endpoints were locoregional recurrence (LRR) and distant metastasis (DM).

Results

With a median follow-up of 62.0 months, multivariate analysis identified the following independent risk factors for increased LRR: tumor size ≥ 4 cm (HR: 2.994, 95% CI: 1.190–7.535, P = 0.020), ER- and PR-negative tumor (HR: 2.540, 95% CI: 1.165–5.537, P = 0.019), preoperative high neutrophil-to-lymphocyte ratio (NLR) (HR: 4.716, 95% CI: 1.776–12.528, P = 0.002)and low neutrophil-to-monocyte ratio (NMR) (HR: 0.231, 95% CI: 0.084–0.633, P = 0.004). And independent risk factors for increased DM: ER- and PR-negative tumor (HR: 2.540, 95% CI: 1.880–5.625, P = 0.000), high NLR (HR: 2.693, 95% CI: 1.426–5.084, P = 0.002) and low NMR (HR: 0.460, 95% CI: 0.257–0.824, P = 0.009). The high-risk patients (≥ 2 risk factors) had worse LRRFS and DFS than low-risk patients (0–1 risk factor) (all, P < 0.05). In the subgroup analysis, both low- and high-risk patients received PMRT had better LRRFS and DFS than those who without PMRT (all, P < 0.05), and the high-risk patients received PMRT had similar 5-year rates of LRRFS and DFS than low-risk patients who without PMRT (94.5 vs. 94.3%, P = 0.402; 83.4 vs.87.4%, P = 0.877, respectively).

Conclusions

Tumor size, ER/PR status, preoperative NLR and NMR were independent predictors of risk of recurrence. PMRT could improve locoregional control even in low-risk subgroup of breast cancer patients with T1–2 tumors and 1–3 positive lymph nodes significantly.

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Data availability

The datasets during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Funding

This study was funded by the Science and Technology Plan Project of Shenyang(19–112-4–083), Science and Technology Plan Project of Liaoning Province of China (201602452, 20180540129, and 20180530095), Key Laboratory of Tumor Radiosensitization and Normal Tissue Radioprotection Project of Liaoning Province (No. 2018225102), and the Personnel Training Project of Liaoning Cancer Hospital & Institute of China (201703).

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Authors and Affiliations

  1. Department of Radiation Oncology, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, No. 44 Xiaoheyan Road, Dadong District, Shenyang, 110042, Liaoning Province, China

    Jia-ming Zhao, Qi An, Chao-nan Sun, Yu-bing Li, Zi-lan Qin, Hong Guo, Xue Zeng, Yao-tian Zhang, Lin-lin Wei, Ning Han, Shi-chen Sun & Na Zhang

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  1. Jia-ming Zhao
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  2. Qi An
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  3. Chao-nan Sun
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  12. Na Zhang
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Correspondence to Na Zhang.

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Zhao, Jm., An, Q., Sun, Cn. et al. Prognostic factors for breast cancer patients with T1–2 tumors and 1–3 positive lymph nodes and the role of postmastectomy radiotherapy in these patients. Breast Cancer 28, 298–306 (2021). https://doi.org/10.1007/s12282-020-01158-0

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  • DOI: https://doi.org/10.1007/s12282-020-01158-0

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