1Department of Radiation Oncology, Seoul National University Hospital, Seoul, Korea
2Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Korea
3Department of Radiation Oncology, Seoul National University Bundang Hospital, Seongnam, Korea
Copyright © 2023 by the Korean Cancer Association
This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Ethical Statement
The institutional review boards of all the participating institutions approved this study. The requirement for informed consent was waived due to the retrospective study design.
Author Contributions
Conceived and designed the analysis: Kim D, Shin KH.
Collected the data: Kim D, Kim JH, Kim IA, Chang JH, Shin KH.
Contributed data or analysis tools: Kim D, Shin KH.
Performed the analysis: Kim D, Shin KH.
Wrote the paper: Kim D, Kim JH, Kim IA, Chang JH, Shin KH.
Conflicts of Interest
Conflict of interest relevant to this article was not reported.
Characteristic | PMRT (n=257) | No PMRT (n=57) | p-value |
---|---|---|---|
Age (yr), median (range) | 48 (25–75) | 47 (30–69) | 0.93 |
Histologic grade | |||
I–II | 133 (51.8) | 30 (52.6) | 0.90 |
III | 124 (48.2) | 27 (47.4) | |
Molecular subtype | |||
Luminal HER2(−) | 71 (27.6) | 20 (35.1) | 0.20 |
HER2(+) | 136 (52.9) | 29 (50.9) | |
Triple-negative | 50 (19.5) | 8 (14.0) | |
Ki-67 (%) | |||
< 15 | 115 (44.7) | 21 (36.8) | 0.28 |
≥ 15 | 142 (55.3) | 36 (63.2) | |
Resection margin status | |||
Negative | 250 (97.3) | 54 (94.7) | 0.32 |
Close | 7 (2.7) | 3 (5.3) | |
Axillary surgery | |||
SLNB | 129 (50.2) | 31 (54.4) | 0.57 |
ALND | 128 (49.8) | 26 (45.6) | |
Lymphovascular invasion | |||
Absent | 216 (84.0) | 51 (89.5) | 0.30 |
Present | 41 (16.0) | 6 (10.5) | |
Clinical T category | |||
cT1-2 | 146 (56.8) | 42 (73.7) | 0.02a) |
cT3-4 | 111 (43.2) | 15 (26.3) | |
Clinical N category | |||
cN0-1 | 107 (41.6) | 44 (77.2) | < 0.001a) |
cN2-3 | 150 (58.4) | 13 (22.8) | |
ypT category | |||
ypT0-is | 202 (78.6) | 43 (75.4) | 0.60 |
ypT1-4 | 55 (21.4) | 14 (24.6) | |
Anti-HER2 therapy | |||
No | 121 (47.1) | 28 (49.1) | 0.78 |
Yes | 136 (52.9) | 29 (50.9) | |
Adjuvant chemotherapy | |||
No | 242 (94.2) | 51 (89.5) | 0.20 |
Yes | 15 (5.8) | 6 (10.5) |
Variable | LRRFS | DFS | OS | |||
---|---|---|---|---|---|---|
HR (95% CI) | p-value | HR (95% CI) | p-value | HR (95% CI) | p-value | |
Histologic grade (III vs. I–II) | - | - | - | - | 2.30 (0.46–11.46) | 0.31 |
Molecular subtype | ||||||
Luminal HER2(−) | Reference | Reference | Reference | |||
HER2(+) | 0.37 (0.02–5.86) | 0.48 | 1.11 (0.34–3.62) | 0.86 | 0.73 (0.04–12.63) | 0.83 |
Triple-negative | 6.82 (0.83–55.48) | 0.07 | 3.71 (1.29–10.61) | 0.02a) | 10.4 (1.25–87.40) | 0.03a) |
Ki-67 ≥ 15% | NA | NA | 3.36 (1.24–9.12) | 0.02a) | - | - |
Lymphovascular invasion (present vs. absent) | - | - | 2.61 (1.11–6.13) | 0.03a) | 2.48 (0.63–9.73) | 0.19 |
ypT category (ypT1–4 vs. T0-is) | - | - | 1.95 (0.80–4.74) | 0.14 | 1.81 (0.42–7.85) | 0.43 |
Characteristic | PMRT (n=339) | No PMRT (n=29) | p-value |
---|---|---|---|
Age (yr) | 46 (25–80) | 48 (37–68) | 0.19 |
Histologic grade | |||
I–II | 223 (65.8) | 18 (62.1) | 0.69 |
III | 116 (34.2) | 11 (37.9) | |
Molecular subtype | |||
Luminal HER2(−) | 199 (58.7) | 19 (65.5) | 0.23 |
HER2(+) | 93 (27.4) | 4 (13.8) | |
Triple-negative | 47 (13.9) | 6 (20.7) | |
Ki-67 (%) | |||
< 15 | 194 (57.2) | 11 (37.9) | 0.045a) |
≥ 15 | 145 (42.8) | 18 (62.1) | |
Resection margin status | |||
Negative | 302 (89.1) | 24 (82.8) | 0.30 |
Close | 37 (10.9) | 5 (17.2) | |
Axillary surgery | |||
SLNB | 29 (8.6) | 3 (10.3) | 0.74 |
ALND | 310 (91.4) | 26 (89.7) | |
Lymphovascular invasion | |||
Absent | 151 (44.5) | 11 (37.9) | 0.49 |
Present | 188 (55.5) | 18 (62.1) | |
Clinical T category | |||
cT1–2 | 170 (50.1) | 20 (69.0) | 0.052 |
cT3–4 | 169 (49.9) | 9 (31.0) | |
Clinical N category | |||
cN0 | 9 (2.7) | 0 (3.4) | 0.42 |
cN1 | 102 (30.1) | 12 (41.4) | |
cN2–3 | 228 (67.3) | 16 (55.2) | |
ypT category | |||
ypT0-is | 13 (3.8) | 0 | 0.28 |
ypT1–4 | 326 (96.2) | 29 (100) | |
ypN category | |||
ypN1 | 195 (57.5) | 18 (62.1) | 0.63 |
ypN2–3 | 144 (42.5) | 11 (37.9) | |
Anti-HER2 therapy | |||
No | 246 (72.6) | 25 (86.2) | 0.11 |
Yes | 93 (27.4) | 4 (13.8) | |
Adjuvant chemotherapy | |||
No | 298 (87.9) | 22 (75.9) | 0.07 |
Yes | 41 (12.1) | 7 (24.1) |
Variable | LRRFS | DFS | OS | |||
---|---|---|---|---|---|---|
HR (95% CI) | p-value | HR (95% CI) | p-value | HR (95% CI) | p-value | |
Age < 40 yr | - | - | - | - | - | - |
Histologic grade (III vs. I–II) | 3.67 (1.59–8.44) | 0.002a) | 2.57 (1.63–4.04) | < 0.001a) | 3.08 (1.71–5.54) | < 0.001a) |
Molecular subtype | ||||||
Luminal HER2(−) | Reference | Reference | Reference | |||
HER2(+) | 1.22 (0.48–3.12) | 0.67 | 0.68 (0.39–1.16) | 0.15 | 0.66 (0.30–1.46) | 0.31 |
Triple-negative | 2.27 (0.89–5.74) | 0.09 | 2.48 (1.44–4.28) | 0.001a) | 4.13 (2.14–7.94) | < 0.001a) |
Ki-67 ≥ 15% | - | - | 0.86 (0.54–1.38) | 0.54 | 0.77 (0.40–1.47) | 0.43 |
Axillary dissection (ALND vs. SLNB) | - | - | 1.70 (0.53–5.49) | 0.38 | - | - |
Lymphovascular invasion (present vs. absent) | 2.38 (1.00–5.65) | 0.045a) | 2.45 (1.54–3.88) | < 0.001a) | 2.07 (1.15–3.73) | 0.02a) |
Clinical T category (cT3–4 vs. cT1–2) | - | - | 1.67 (1.10–2.54) | 0.02a) | 2.03 (1.17–3.51) | 0.01a) |
Clinical N category | ||||||
cN0 | - | - | Reference | - | - | |
cN1 | - | - | 1.72 (0.23–12.9) | 0.60 | - | - |
cN2–3 | - | - | 2.06 (0.28–15.0) | 0.48 | - | - |
ypN stage (ypN2–3 vs. ypN1) | 2.37 (1.13–5.00) | 0.02a) | 2.35 (1.54–3.57) | < 0.001a) | 2.98 (1.72–5.17) | < 0.001a) |
Radiation therapy done | 0.11 (0.05–0.25) | < 0.001a) | 0.29 (0.16–0.54) | < 0.001a) | 0.13 (0.06–0.29) | < 0.001a) |
ALND, axillary lymph node dissection; CI, confidence interval; DFS, disease-free survival; HER2, human epidermal growth factor receptor; HR, hazard ratio; LRRFS, locoregional recurrence-free survival; LVI, lymphovascular invasion; OS, overall survival; RM, resection margin; SLNB, sentinel lymph node biopsy.
a) Significant p-value.
Characteristic | PMRT (n=257) | No PMRT (n=57) | p-value |
---|---|---|---|
Age (yr), median (range) | 48 (25–75) | 47 (30–69) | 0.93 |
Histologic grade | |||
I–II | 133 (51.8) | 30 (52.6) | 0.90 |
III | 124 (48.2) | 27 (47.4) | |
Molecular subtype | |||
Luminal HER2(−) | 71 (27.6) | 20 (35.1) | 0.20 |
HER2(+) | 136 (52.9) | 29 (50.9) | |
Triple-negative | 50 (19.5) | 8 (14.0) | |
Ki-67 (%) | |||
< 15 | 115 (44.7) | 21 (36.8) | 0.28 |
≥ 15 | 142 (55.3) | 36 (63.2) | |
Resection margin status | |||
Negative | 250 (97.3) | 54 (94.7) | 0.32 |
Close | 7 (2.7) | 3 (5.3) | |
Axillary surgery | |||
SLNB | 129 (50.2) | 31 (54.4) | 0.57 |
ALND | 128 (49.8) | 26 (45.6) | |
Lymphovascular invasion | |||
Absent | 216 (84.0) | 51 (89.5) | 0.30 |
Present | 41 (16.0) | 6 (10.5) | |
Clinical T category | |||
cT1-2 | 146 (56.8) | 42 (73.7) | 0.02 |
cT3-4 | 111 (43.2) | 15 (26.3) | |
Clinical N category | |||
cN0-1 | 107 (41.6) | 44 (77.2) | < 0.001 |
cN2-3 | 150 (58.4) | 13 (22.8) | |
ypT category | |||
ypT0-is | 202 (78.6) | 43 (75.4) | 0.60 |
ypT1-4 | 55 (21.4) | 14 (24.6) | |
Anti-HER2 therapy | |||
No | 121 (47.1) | 28 (49.1) | 0.78 |
Yes | 136 (52.9) | 29 (50.9) | |
Adjuvant chemotherapy | |||
No | 242 (94.2) | 51 (89.5) | 0.20 |
Yes | 15 (5.8) | 6 (10.5) |
ALND, axillary lymph node dissection; HER2, human epidermal growth factor receptor; PMRT, postmastectomy radiation therapy; SLNB, sentinel lymph node biopsy.
a)Significant p-value.
Variable | LRRFS | DFS | OS | |||
---|---|---|---|---|---|---|
HR (95% CI) | p-value | HR (95% CI) | p-value | HR (95% CI) | p-value | |
Histologic grade (III vs. I–II) | - | - | - | - | 2.30 (0.46–11.46) | 0.31 |
Molecular subtype | ||||||
Luminal HER2(−) | Reference | Reference | Reference | |||
HER2(+) | 0.37 (0.02–5.86) | 0.48 | 1.11 (0.34–3.62) | 0.86 | 0.73 (0.04–12.63) | 0.83 |
Triple-negative | 6.82 (0.83–55.48) | 0.07 | 3.71 (1.29–10.61) | 0.02 |
10.4 (1.25–87.40) | 0.03 |
Ki-67 ≥ 15% | NA | NA | 3.36 (1.24–9.12) | 0.02 |
- | - |
Lymphovascular invasion (present vs. absent) | - | - | 2.61 (1.11–6.13) | 0.03 |
2.48 (0.63–9.73) | 0.19 |
ypT category (ypT1–4 vs. T0-is) | - | - | 1.95 (0.80–4.74) | 0.14 | 1.81 (0.42–7.85) | 0.43 |
CI, confidence interval; DFS, disease-free survival; HER2, human epidermal growth factor receptor; HR, hazard ratio; LRRFS, locoregional recurrence-free survival; NA, not available; OS, overall survival.
a)Significant p-value.
Characteristic | PMRT (n=339) | No PMRT (n=29) | p-value |
---|---|---|---|
Age (yr) | 46 (25–80) | 48 (37–68) | 0.19 |
Histologic grade | |||
I–II | 223 (65.8) | 18 (62.1) | 0.69 |
III | 116 (34.2) | 11 (37.9) | |
Molecular subtype | |||
Luminal HER2(−) | 199 (58.7) | 19 (65.5) | 0.23 |
HER2(+) | 93 (27.4) | 4 (13.8) | |
Triple-negative | 47 (13.9) | 6 (20.7) | |
Ki-67 (%) | |||
< 15 | 194 (57.2) | 11 (37.9) | 0.045 |
≥ 15 | 145 (42.8) | 18 (62.1) | |
Resection margin status | |||
Negative | 302 (89.1) | 24 (82.8) | 0.30 |
Close | 37 (10.9) | 5 (17.2) | |
Axillary surgery | |||
SLNB | 29 (8.6) | 3 (10.3) | 0.74 |
ALND | 310 (91.4) | 26 (89.7) | |
Lymphovascular invasion | |||
Absent | 151 (44.5) | 11 (37.9) | 0.49 |
Present | 188 (55.5) | 18 (62.1) | |
Clinical T category | |||
cT1–2 | 170 (50.1) | 20 (69.0) | 0.052 |
cT3–4 | 169 (49.9) | 9 (31.0) | |
Clinical N category | |||
cN0 | 9 (2.7) | 0 (3.4) | 0.42 |
cN1 | 102 (30.1) | 12 (41.4) | |
cN2–3 | 228 (67.3) | 16 (55.2) | |
ypT category | |||
ypT0-is | 13 (3.8) | 0 | 0.28 |
ypT1–4 | 326 (96.2) | 29 (100) | |
ypN category | |||
ypN1 | 195 (57.5) | 18 (62.1) | 0.63 |
ypN2–3 | 144 (42.5) | 11 (37.9) | |
Anti-HER2 therapy | |||
No | 246 (72.6) | 25 (86.2) | 0.11 |
Yes | 93 (27.4) | 4 (13.8) | |
Adjuvant chemotherapy | |||
No | 298 (87.9) | 22 (75.9) | 0.07 |
Yes | 41 (12.1) | 7 (24.1) |
Values are presented as median (range) or number (%). ALND, axillary lymph node dissection; HER2, human epidermal growth factor receptor; PMRT, postmastectomy radiation therapy; SLNB, sentinel lymph node biopsy.
a)Significant p-value.
Variable | LRRFS | DFS | OS | |||
---|---|---|---|---|---|---|
HR (95% CI) | p-value | HR (95% CI) | p-value | HR (95% CI) | p-value | |
Age < 40 yr | - | - | - | - | - | - |
Histologic grade (III vs. I–II) | 3.67 (1.59–8.44) | 0.002 |
2.57 (1.63–4.04) | < 0.001 |
3.08 (1.71–5.54) | < 0.001 |
Molecular subtype | ||||||
Luminal HER2(−) | Reference | Reference | Reference | |||
HER2(+) | 1.22 (0.48–3.12) | 0.67 | 0.68 (0.39–1.16) | 0.15 | 0.66 (0.30–1.46) | 0.31 |
Triple-negative | 2.27 (0.89–5.74) | 0.09 | 2.48 (1.44–4.28) | 0.001 |
4.13 (2.14–7.94) | < 0.001 |
Ki-67 ≥ 15% | - | - | 0.86 (0.54–1.38) | 0.54 | 0.77 (0.40–1.47) | 0.43 |
Axillary dissection (ALND vs. SLNB) | - | - | 1.70 (0.53–5.49) | 0.38 | - | - |
Lymphovascular invasion (present vs. absent) | 2.38 (1.00–5.65) | 0.045 |
2.45 (1.54–3.88) | < 0.001 |
2.07 (1.15–3.73) | 0.02 |
Clinical T category (cT3–4 vs. cT1–2) | - | - | 1.67 (1.10–2.54) | 0.02 |
2.03 (1.17–3.51) | 0.01 |
Clinical N category | ||||||
cN0 | - | - | Reference | - | - | |
cN1 | - | - | 1.72 (0.23–12.9) | 0.60 | - | - |
cN2–3 | - | - | 2.06 (0.28–15.0) | 0.48 | - | - |
ypN stage (ypN2–3 vs. ypN1) | 2.37 (1.13–5.00) | 0.02 |
2.35 (1.54–3.57) | < 0.001 |
2.98 (1.72–5.17) | < 0.001 |
Radiation therapy done | 0.11 (0.05–0.25) | < 0.001 |
0.29 (0.16–0.54) | < 0.001 |
0.13 (0.06–0.29) | < 0.001 |
ALND, axillary lymph node dissection; CI, confidence interval; DFS, disease-free survival; HER2, human epidermal growth factor receptor; HR, hazard ratio; LRRFS, locoregional recurrence-free survival; LVI, lymphovascular invasion; OS, overall survival; RM, resection margin; SLNB, sentinel lymph node biopsy.
a)Significant p-value.
ALND, axillary lymph node dissection; HER2, human epidermal growth factor receptor; PMRT, postmastectomy radiation therapy; SLNB, sentinel lymph node biopsy. Significant p-value.
CI, confidence interval; DFS, disease-free survival; HER2, human epidermal growth factor receptor; HR, hazard ratio; LRRFS, locoregional recurrence-free survival; NA, not available; OS, overall survival. Significant p-value.
Values are presented as median (range) or number (%). ALND, axillary lymph node dissection; HER2, human epidermal growth factor receptor; PMRT, postmastectomy radiation therapy; SLNB, sentinel lymph node biopsy. Significant p-value.
ALND, axillary lymph node dissection; CI, confidence interval; DFS, disease-free survival; HER2, human epidermal growth factor receptor; HR, hazard ratio; LRRFS, locoregional recurrence-free survival; LVI, lymphovascular invasion; OS, overall survival; RM, resection margin; SLNB, sentinel lymph node biopsy. Significant p-value.