نبذة مختصرة : Introduction. Indications for radiation therapy after mastectomies with/without reconstruction at T12N01M0 remain unclear; treatment standards contain references to the possible administration of radiation therapy for factors that increase breast cancer recurrence. Materials and methods. A retrospective singlecenter, nonrandomized study enrolled 984 breast cancer patients treated at P.A. Gertsen Moscow Cancer Research Institute from 2014 to 2022. Patients were divided into 2 groups: a radiotherapy group and a nonradiotherapy group. Results and discussion. The paper presents an analysis of patients’ age, the histological structure of the tumor, immunohistochemical characteristics, tumor grade, multicentricity, presence of lymphovascular invasion, tumor cells, the state of R1 and R0 margins, and the tumor stage at risk of recurrence. Overall survival in the recurrence group accounted for 95.1%, in the nonrecurrence group – 98.4%. In the radiotherapy group (group I), the overall survival comprised 98.4%; metastases were diagnosed in 4.9% of cases. In thenonradiotherapy group (group II), the overall survival amounted to 98.2%; metastases were revealed in 5.9% of cases. Conclusion. Univariate analysis in the study groups showed that radiation therapy reduced the risk of relapse by 3.5%. In case of positive R1 margin, radiotherapy is recommended, which was confirmed in our study, the difference accounted for 14.5%, and in the presence of R1, radiotherapy is claimed to be necessary in the postoperative period. When analyzing the stage of breast cancer and the risk of recurrence, the statistical difference was revealed only at stage IIA (T1N1M0); radiation therapy reduced the risk of breast cancer recurrence. The statistical difference in groups I and II was detected at Grade 2 tumor, Ki67 level less than 50%, presence of tumor embolism and age of patients under 40 years. Radiation therapy after subcutaneous/skinsparing mastectomy reduces the recurrence risk by 3.2%; however, the overall survival in group I and ...
Relation: https://www.surgonco.ru/jour/article/view/985/615; Рассказова Е.А., Зикиряходжаев А.Д., Каприн А.Д. Рецидивы и отдаленные метастазы после радикальных подкожных и кожесохранных мастэктомий с реконструкцией при раке молочной железы. Врач. 2023:34(10):58–62. DOI:10.29296/25877305-2023-10-11; Huo X., Li J., Zhao F., Ren D., Ahmad R., Yuan X., et al. The role of capecitabinebased neoadjuvant and adjuvant chemotherapy in early- stage triple-negative breast cancer: a systematic review and meta-analysis. BMC Cancer. 2021;21(1):78. DOI:10.1186/s12885-021-07791-y; Ортабаева Д.Р., Зикиряходжаев А. Д., Рассказова Е. А., Сарибекян Э.К., Каприн А.Д. Отдаленные онкологические результаты органосохраняющего лечения без послеоперационной лучевой терапии у больных ранним раком молочной железы старше 65 лет. Опухоли женской репродуктивной системы. 2022;18(3):24–8. DOI:10.17650/1994-4098-2022-18-3-24-28; Hong M.J., Lum S.S., Dupont E., Howard-McNatt M., Chiba A., Levine E.A., et al. Omission of radiation in conservative treatment for breast cancer: opportunity for de-escalation of care. J Surg Res. 2022;279:393– 7. DOI:10.1016/j.jss.2022.06.036; Verma R., Chandarana M., Barrett J., Anandadas C., Sundara Rajan S. Post-mastectomy radiotherapy for women with early breast cancer and one to three positive lymph nodes. Cochrane Database Syst Rev. 2023;6(6):CD014463. DOI:10.1002/14651858.CD014463.pub2; Jafer F., Malki S., Akram M., Gulwarisdotter T., Karakatsanis A., Valachis A. Postmastectomy radiation therapy in breast cancer patients with micrometastatic disease in sentinel node dissection: A cohort study and meta-analysis. Clin Transl Radiat Oncol. 2024;46:100770. DOI:10.1016/j.ctro.2024.100770; Zeidan Y.H., Habib J.G., Ameye L., Paesmans M., de Azambuja E., Gelber R.D., et al. Postmastectomy radiation therapy in women with T1-T2 tumors and 1 to 3 positive lymph nodes: analysis of the Breast International Group 02-98 Trial. Int J Radiat Oncol Biol Phys. 2018;101(2):316–24. DOI:10.1016/j.ijrobp.2018.01.105; Lai S.F., Huang C.S., Kuo S.H. Whether adjuvant radiotherapy is desired for postmastectomy patients with T1-T2 tumors and 1-3 positive axillary lymph nodes who received modern systemic therapy? Transl Cancer Res. 2019;8(Suppl 2):S110–4. DOI:10.21037/tcr.2018.11.18; Золотой стандарт профилактики, диагностики, лечения и реабилитации больных РМЖ. М.; 2024.; Дуадзе И.С., Каприн А.Д., Зикиряходжаев А. Д., Решетов И.В., Усов Ф.Н., Рассказова Е.А. и др. Влияние лучевой терапии на развитие осложнений при одномоментной аутологичной реконструкции молочной железы DIEP-лоскутом у больных раком молочной железы. Современная онкология. 2023:25(1):68– 72. DOI:10.26442/18151434.2023.1.202080; Munder B., Andree C., Witzel C., Fertsch S., Stambera P., Schulz T., et al. The DIEP flap as well-established method of choice for autologous breast reconstruction with a low complication rate — retrospective single-centre 10-year experience. Geburtshilfe Frauenheilkd. 2020;80(6):628–38. DOI:10.1055/a-1116-2102; Halfteck G.G., Polychronopoulou Y.E., Haque W., Weiser R., Hatch S.S., Klimberg V.S. De-escalation of post-mastectomy irradiation in hormone receptor-positive breast cancer with one to three positive nodes. Ann Surg Oncol. 2023;30(13):8335–43. DOI:10.1245/s10434-023-14155-2; Zhang N., Zhang J., Zhang H., Liu Y., Zhao W., Wang L., Individualized Prediction of survival benefit from postmastectomy radiotherapy for patients with breast cancer with one to three positive axillary lymph nodes. Oncologist. 2019;24(12):e1286–93. DOI:10.1634/theoncologist.2019-0124; Wang S., Wen G., Tang Y., Yang Y., Jing H., Wang J., et al. Effectiveness of the AJCC 8th edition staging system for selecting patients with T1- 2N1 breast cancer for post-mastectomy radiotherapy: a joint analysis of 1986 patients from two institutions. BMC Cancer. 2020;20(1):792. DOI:10.1186/s12885-020-07267-5; Velikova G., Williams L.J., Willis S., Dixon J.M., Loncaster J., Hatton M., et al. Quality of life after postmastectomy radiotherapy in patients with intermediate-risk breast cancer (SUPREMO): 2-year follow-up results of a randomised controlled trial. Lancet Oncol. 2018;19(11):1516– 29. DOI:10.1016/S1470-2045(18)30515-1; Ульрих Д.Г., Криворотько П.В., Брянцева Ж.В., Песоцкий Р.С., Бондарчук Я.И., Амиров Н.С. и др. Реконструктивно- пластические операции в комбинированном лечении рака молочной железы: факторы риска осложнений и реконструктивных неудач. Онкология. Журнал им. П.А. Герцена. 2024;13(3):13–9. DOI:10.17116/onkolog20241303113; https://www.surgonco.ru/jour/article/view/985
Rights: Authors who publish with this journal agree to the following terms:Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access). ; Авторы, публикующие статью в данном журнале, соглашаются со следующим:Авторы сохраняют за собой авторские права на работу и предоставляют журналу право первой публикации работы на условиях лицензии Creative Commons Attribution License, которая позволяет другим распространять данную работу с обязательным сохранением ссылок на авторов оригинальной работы и оригинальную публикацию в этом журнале.Авторы сохраняют право заключать отдельные контрактные договорённости, касающиеся не-эксклюзивного распространения версии работы в опубликованном здесь виде (например, размещение ее в институтском хранилище, публикацию в книге), со ссылкой на ее оригинальную публикацию в этом журнале.Авторы имеют право размещать их работу в сети Интернет (например в институтском хранилище или персональном сайте) до и во время процесса рассмотрения ее данным журналом, так как это может привести к продуктивному обсуждению и большему количеству ссылок на данную работу (См. The Effect of Open Access).
No Comments.