Effect of Postmastectomy Radiotherapy in Patients <35 Years Old With Stage II-III Breast Cancer Treated With Doxorubicin-Based Neoadjuvant Chemotherapy and Mastectomy

• Published in: International journal of radiation oncology, biology, physics Vol. 69; no. 5; pp. 1478 - 1483
• Main Authors: Garg, Amit K., M.D, Oh, Julia L., M.D, Oswald, Mary Jane, B.S, Huang, Eugene, M.D, Strom, Eric A., M.D, Perkins, George H., M.D, Woodward, Wendy A., M.D., Ph.D, Yu, T. Kuan, M.D., Ph.D, Tereffe, Welela, M.D, Meric-Bernstam, Funda, M.D, Hahn, Karin, M.D, Buchholz, Thomas A., M.D
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-12-2007
• Subjects: Adult; Age Factors; Breast Neoplasms - drug therapy; Breast Neoplasms - pathology; Breast Neoplasms - radiotherapy; Breast Neoplasms - surgery; CARCINOMAS; CHEMOTHERAPY; Chemotherapy, Adjuvant; DIAGNOSIS; DOXORUBICIN; Doxorubicin - therapeutic use; Female; HEALTH HAZARDS; Hematology, Oncology and Palliative Medicine; Humans; Lymphatic Metastasis; MAMMARY GLANDS; Mastectomy; neoadjuvant chemotherapy; Neoadjuvant Therapy; Neoplasm Recurrence, Local; Neoplasm Staging; PATIENTS; Radiation therapy; Radiology; RADIOLOGY AND NUCLEAR MEDICINE; RADIOTHERAPY; Retrospective Studies; Survival Analysis; young age; neoadjuvant chemotherapy; mastectomy; young age; Radiation therapy
• ISSN: 0360-3016; 1879-355X
• DOI: 10.1016/j.ijrobp.2007.05.029

Purpose Postmastectomy radiotherapy (PMRT) improves locoregional control (LRC) in patients with high-risk features after mastectomy. Young age continues to evolve as a potentially important risk factor. The objective of this study was to assess the benefits of PMRT in patients <35 years old treated with doxorubicin-based neoadjuvant chemotherapy for Stage II-III breast cancer. Patients and Methods We retrospectively analyzed 107 consecutive breast cancer patients <35 years old with Stage IIA-IIIC disease treated at our institution with doxorubicin-based neoadjuvant chemotherapy and mastectomy, with or without PMRT. The treatment groups were compared in terms of LRC and overall survival. Results Despite more advanced disease stages, the patients who received PMRT ( n = 80) had greater rates of LRC (5-year rate, 88% vs. 63%, p = 0.001) and better overall survival (5-year rate, 67% vs. 48%, p = 0.03) than patients who did not receive PMRT ( n = 27). Conclusion Among breast cancer patients <35 years old at diagnosis, the use of PMRT after doxorubicin-based neoadjuvant chemotherapy and mastectomy led to a statistically greater rate of LRC and overall survival compared with patients without PMRT. The benefit seen for PMRT in young patients provides valuable data to better tailor adjuvant, age-specific treatment decisions after mastectomy.