Locoregional failure 15 years after mastectomy in XXXX with one to three positive axillary nodes with or without irradiation the significance of @entity5 size.

@entity1 @entity5 @entity138
BACKGROUND: There is insufficient evidence to suggest the routine use of postmastectomy radiotherapy (PMRT) in @entity1 with one to three positive axillary nodes and @entity5 . We have assessed the risk of locoregional recurrence (LRR) with or without @entity138 in this group of @entity1 , and focused on the results in subgroups defined by @entity5 size. @entity1 AND METHODS: 249 @entity1 with @entity5 and one to three positive nodes underwent mastectomy and axillary dissection between 1983 and 1987. Locoregional @entity138 of 50 Gy was given to 175 @entity1 . Chemotherapy or hormonal therapy was administered to 41 and 71 @entity1 , respectively. The median follow-up time of survivors was 189 months (range, 167-227 months). RESULTS: The rates of isolated LRR without or with @entity138 were 16% (12/74) and 8% (14/175), respectively (p = 0.05), and the total (with or without distant relapse) LRR rates 23% and 12%, respectively (p = 0.03). 15-year overall survival amounted to 41% without @entity138 and to 52% with @entity138 (p = 0.2). The rates of isolated LRR for @entity1 treated with chemotherapy or hormonal therapy only were 25% and 12%, respectively. In the absence of @entity138 , age (> 45 vs = 45 years; p = 0.06), @entity5 size (T1 vs T2; p = 0.07), and extranodal invasion (ENI; absent vs present; p = 0.09) were related to the risk of developing an isolated LRR. On multivariate analysis, only @entity5 size (relative risk [RR], 3.92; 95% confidence interval [CI], 1.11-15.14) and age (RR, 3.37; 95% CI, 1.03-11.09) emerged as independent significant predictors, whereas ENI (RR, 1.50; 95% CI, 0.81-2.77) did not. In the T1 subgroup, the estimated 15-year isolated LRR rate was 9% (3/36) without and 9% (8/99) with @entity138 (p = 0.9775). 15-year disease-free survival amounted to 62% and 57%, respectively (p = 0.5153). For @entity1 without @entity138 , according to the age groups (= 45 vs > 45 years), the 15-year rates of isolated LRR were 9% and 9%, respectively (p = 0.9910). In the T2 subgroup, the estimated 15-year isolated LRR rate was 30% (9/38) without and 10% (6/76) with @entity138 (RR, 0.33; 95% CI, 0.12-0.92; p = 0.0244). 15-year disease-free survival amounted to 32% and 50%, respectively (p = 0.1213). For @entity1 without @entity138 , according to the age groups (< or = 45 vs > 45 years), the 15-year rates of isolated LRR were 57% and 16%, respectively (p = 0.0049). CONCLUSION: @entity1 with T1 @entity5 and one to three positive nodes are at low risk of isolated LRR either with or without @entity138 . @entity1 with T2 @entity5 and one to three positive nodes are at high risk of isolated LRR without @entity138 . Our findings support the routine use of PMRT in @entity1 with T2 @entity5 , especially those aged < or = 45 years.
