Postmastectomy radiation therapy in early breast cancer: Utility or futility?

Crit Rev Oncol Hematol. 2020 Mar:147:102887. doi: 10.1016/j.critrevonc.2020.102887. Epub 2020 Jan 30.

Abstract

Postmastectomy radiation therapy (PMRT) has been shown to reduce the risk of locoregional recurrence (LRR), in patients with locally advanced breast cancer who are considered of high-risk because of large tumors (>5 cm) or presence of axillary lymph-node involvement, as well as to reduce breast cancer mortality. However, controversy still remains with respect to indication of PMRT in case of early-stages invasive tumors. This review aims to analyze the impact that PMRT has on final results in women with breast tumors in different scenarios that would otherwise be considered as early breast cancer, such as extensive DCIS, tumors without axillary lymph-node involvement or with minimal microscopic nodal-involvement. The existence of risk factors including young age, premenopausal status, and presence of lymphovascular invasion (LVI), high grade or tumor size >2 cm has been associated with an increased risk of LRR in these patients at early-stages and advises to consider PMRT in selected cases.

Keywords: Breast cancer; Early stages; Local control; Overall survival; Postmastectomy radiotherapy.

Publication types

  • Review

MeSH terms

  • Breast Neoplasms / mortality
  • Breast Neoplasms / pathology
  • Breast Neoplasms / radiotherapy*
  • Breast Neoplasms / surgery
  • Female
  • Humans
  • Lymph Node Excision
  • Mastectomy
  • Medical Futility
  • Neoplasm Recurrence, Local
  • Neoplasm Staging
  • Radiotherapy, Adjuvant*
  • Retrospective Studies
  • Survival