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J Korean Soc Ther Radiol Oncol > Volume 19(4); 2001 > Article
The Journal of the Korean Society for Therapeutic Radiology and Oncology 2001;19(4): 312-318.
Postoperative Radiation Therapy in High-risk Breast Cancer
Kyung Ja Lee
ABSTRACT
PURPOSE:
To assess the locoregional recurrence rate, survival rate and prognostic factors after modified radical mastectomy and postoperative adjuvant radiation therapy with or with chemotherapy in high-risk breast cancer patients.
METHODS:
Between 1984-1995, 48 patients underwent postoperative irradiation to the regional lymphatics and chest wall due to large tumor size (> or = 5 cm) or small tumor size (<5 cm) with axillary lymph node involvement after modified radical mastectomy. The median age of the patients was 47 years (range, 31-79 years). The clinical tumor size was <2 cm in 1 patient, 2-5 cm in 15 patients, and >5 cm in 32 patients. Thirty two patients had positive axillary lymph nodes. Forty two patients were irradiated to the chest wall and regional lymph node and 6 patients were irradiated in the chest wall only. Radiation dose to the chest wall and regional lymph node was 5040 cGy/28 fraction. The median follow-up time was 61 months.
RESULTS:
Locoregional recurrence rate was 8% and distant metastatic rate was 14%. The actuarial overall survival rate and disease-free survival rate was 63% and 62% at 5 years, respectively. The median survival time was 67 months. Five-year overall survival rate by the stage is 70% in IIB and 58% in IIIA. The significant prognostic factor for survival on multivariate analysis was the stage.
CONCLUSION:
Postoperative adjuvant radiation therapy in high-risk breast cancer can reduce the locoregional recurrence rate and increase the survival time by combined chemotherapy. The significant prognostic factor for survival rate was the stage.
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