Is it beneficial for patients with pT1-2N1M0 breast cancer to receive postmastectomy radiotherapy? An analysis based on RecurIndex assay

Int J Cancer. 2021 Nov 15;149(10):1801-1808. doi: 10.1002/ijc.33730. Epub 2021 Aug 3.

Abstract

The benefit of postmastectomy radiotherapy (PMRT) for pT1-2N1M0 breast cancer patients currently remains controversial. This study was conducted to investigate whether pT1-2N1M0 breast cancer patients could benefit from PMRT based on RecurIndex assay. The clinical data of 213 pT1-2N1M0 breast cancer patients were retrospectively analyzed. Through RecurIndex assay, 81 cases were assessed as the low risk, and 132 as the high risk. Compared to low-risk patients, high-risk patients especially those not receiving PMRT had a significantly increased risk of recurrence and metastasis, and worse 7-year local-regional recurrence-free interval (LRFI), distance recurrence-free interval (DRFI) and recurrence-free survival (RFS) rates. PMRT-based subgroup analysis indicated no significant differences between the low-risk patients with and without PMRT in 7-year LRFI, DRFI, RFS and overall survival (OS) rates, but apparent differences were all shown between the high-risk patients with and without PMRT in 7-year LRFI, DRFI, RFS and OS rates. Overall, for pT1-2N1M0 breast cancer patients at low risk of recurrence and metastasis stratified by RecurIndex assay, there may be a phenomenon of no PMRT benefits, while for those at high risk, use of PMRT may produce survival benefits.

Keywords: RecurIndex assay; breast cancer; distant metastasis; local-regional recurrence; postmastectomy radiotherapy.

MeSH terms

  • Adult
  • Aged
  • Breast Neoplasms / pathology
  • Breast Neoplasms / radiotherapy*
  • Breast Neoplasms / surgery*
  • Combined Modality Therapy
  • Female
  • Humans
  • Lymphatic Metastasis
  • Mastectomy / methods*
  • Middle Aged
  • Neoplasm Recurrence, Local
  • Neoplasm Staging
  • Outcome Assessment, Health Care / methods
  • Outcome Assessment, Health Care / statistics & numerical data
  • Postoperative Period
  • Radiotherapy, Adjuvant / methods*
  • Retrospective Studies
  • Risk Factors
  • Survival Analysis