Department of Radiation Oncology, Hospital Universitario HM Sanchinarro, Centro Integral Oncológico Clara Campal (CIOCC), Madrid, Spain; Breast Cancer Unit, Hospital Universitario HM Sanchinarro, Madrid, Spain.
Department of Radiation Oncology, Hospital Universitario HM Sanchinarro, Centro Integral Oncológico Clara Campal (CIOCC), Madrid, Spain; Breast Cancer Unit, Hospital Universitario HM Sanchinarro, Madrid, Spain.
Crit Rev Oncol Hematol. 2020 Mar;147:102887. doi: 10.1016/j.critrevonc.2020.102887. Epub 2020 Jan 30.
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.
术后放疗（PMRT）已被证明可以降低局部晚期乳腺癌患者的局部区域复发（LRR）风险，这些患者被认为是高危人群，因为肿瘤较大（>5cm）或存在腋窝淋巴结受累，以及降低乳腺癌死亡率。然而，在早期浸润性肿瘤的情况下，PMRT 的适应证仍存在争议。本综述旨在分析 PMRT 对不同情况下的乳腺肿瘤患者的最终结果的影响，这些患者在其他方面被认为是早期乳腺癌，如广泛的 DCIS、无腋窝淋巴结受累或仅存在微小的显微镜下淋巴结受累的肿瘤。存在一些危险因素，包括年龄较小、绝经前状态以及存在脉管侵犯（LVI）、高级别或肿瘤大小>2cm，这些患者在早期存在 LRR 风险增加，并建议在某些情况下考虑 PMRT。
