García Novoa Alejandra, Acea Nebril Benigno, Díaz Inma, Builes Ramírez Sergio, Varela Cristina, Cereijo Carmen, Mosquera Oses Joaquín, López Calviño Beatriz, Seoane Pillado María Teresa
Unidad de Mama, Servicio de Cirugía General y del Aparato Digestivo, Complejo Hospitalario Universitario de A Coruña, La Coruña, España.
Unidad de Mama, Servicio de Cirugía General y del Aparato Digestivo, Complejo Hospitalario Universitario de A Coruña, La Coruña, España.
Cir Esp. 2016 Jun-Jul;94(6):331-8. doi: 10.1016/j.ciresp.2016.04.003. Epub 2016 May 30.
INTRODUCTION: Several clinical studies analyze axillary treatment in women with early-stage breast cancer because of changes in the indication for axillary lymph node dissection. The aim of the study is to analyze the impact of axillary radiotherapy in disease-free and overall survival in women with early breast cancer treated with lumpectomy. METHODS: Retrospective study in women with initial stages of breast carcinoma treated by lumpectomy. A comparative analysis of high-risk women with axillary lymph node involvement who received axillary radiotherapy with the group of women with low risk without radiotherapy was performed. Logistic regression was used to determine factors influencing survival and lymphedema onset. RESULTS: A total of 541 women were included in the study: 384 patients (71%) without axillary lymph node involvement and 157 women (29%) with 1-3 axillary lymph node involvement. Patients with axillary radiotherapy had a higher number of metastatic lymph node compared to non-irradiated (1.6±0.7 vs. 1.4±0.6, P=.02). The group of women with axillary lymph node involvement and radiotherapy showed an overall and disease-free survival at 10 years similar to that obtained in patients without irradiation (89.7% and 77.2%, respectively). 3 lymph nodes involved multiplied by more than 7 times the risk of death (HR=7.20; 95% CI: 1.36 to 38.12). The multivariate analysis showed axillary lymph node dissection as the only variable associated with the development of lymphedema. CONCLUSION: The incidence of axillary relapse on stage I and II breast cancer is rare. In these patients axillary radiotherapy does not improve overall survival, but contributes to regional control in those patients with risk factors.
引言:由于腋窝淋巴结清扫术适应证的变化,多项临床研究对早期乳腺癌女性的腋窝治疗进行了分析。本研究的目的是分析腋窝放疗对接受保乳手术治疗的早期乳腺癌女性无病生存期和总生存期的影响。 方法:对接受保乳手术治疗的早期乳腺癌女性进行回顾性研究。对有腋窝淋巴结转移的高危女性接受腋窝放疗组与无放疗的低危女性组进行比较分析。采用逻辑回归确定影响生存和淋巴水肿发生的因素。 结果:本研究共纳入541名女性:384例(71%)无腋窝淋巴结转移,157例(29%)有1 - 3个腋窝淋巴结转移。接受腋窝放疗的患者转移淋巴结数量高于未放疗者(1.6±0.7对1.4±0.6,P = 0.02)。有腋窝淋巴结转移且接受放疗的女性组10年总生存期和无病生存期与未接受放疗的患者相似(分别为89.7%和77.2%)。有3个淋巴结转移使死亡风险增加7倍多(HR = 7.20;95%CI:1.36至38.12)。多因素分析显示腋窝淋巴结清扫术是与淋巴水肿发生相关的唯一变量。 结论:I期和II期乳腺癌腋窝复发的发生率很低。在这些患者中,腋窝放疗并不能提高总生存期,但有助于对有危险因素的患者进行区域控制。
Int J Radiat Oncol Biol Phys. 2000-7-1