Issues Of The Radiotheray For Clinical Stage T_1-2N₁M₀ Breast Cancer Treated With Neoadjuvant Chemotherapy

Purpose1. Discussing the whether different subtypes of breast cancer possess a different prognosis.2. Exploring whether postoperation radiotherapy should be applied among the clinical stage T1-2N1M0 breast cancer treated with neoadjuvant chemotherapy.MethodCollecting the information of breast cancer patients treated with neoadjuvant chemotherapy among 1th January 2005 to 31th December 2010 retrospectively,selecting clinical stage T1-2N1M0 purposefully,using SPSS 20.0 software to analyse the prognosis of Radiation and non-Radiation group,then contrastively analyse our results and overseas studies.ResultTotally selecting 152 cases of Clinical stage T1-2N1M0 Breast cancer patients treated with neoadjuvant chemotherapy,median age is 46 years old (23-72),all the patients confirmed positive lymph nodes before the treatment.The median periodicities of neoadjuvant chemotherapy is 6(2-10).38 cases(25%) are Pathology complete remission,and 36 of them received postoperation-radiotherapy while 2 not received,and the pCR rate of four subtypes is Luminal A(14.3%)、Luminal B(21.9%)、Triple negative(33.3%)、HER-2 positive(50%) The rest 114 patients turned into two groups by lymph node status after neoadjuvantchemotherapy,negative 36 cases(23.7%) and positive 78 cases.Among the negative group,26 cases renceived postoperation-radiotherapy and 10 cases not,Among the positive group,69 cases renceived postoperation-radiotherapy and 9 cases not.The median follow-up time is 83 months (11.5-84.5),53 cases(34.9%) have relapse and metastasis,29 cases died(19.1%).The rate of 3-years and 5-years overall survival is 91% and 84%.The pCR rate of four subtypes have a significant difference(p<0.001).Among pCR group, the 5-year local-recurrence rate of radiation and non-radiation group is 2.8%and 0%(p=0.947).Among the node negative group, the 5-year local-recurrence rate of radiation and non-radiation group is 3.8%and 20%(p=0.181). Among the node positive group, the 5-year local-recurrence rate of radiation and non-radiation group is 14.5%and 33.3%(p=0.167).Afte all,the patients of Luminal A subtype have a better prognosis(p<0.001),and pCR cases have a better disease-free survival too(p<0.001).Conclusion1.Patients of Clinical stage T1-2N1M0 breast cancer have a good efficiency in neoadjuvant chemotherapy,and pCR group differs a better prognosis than non-pCR.Although Triple negative and HER-2 positive group get a higher pCR rates relatively,Luminal A group still differs a better survival than another subtypes.2.Patients of early stage breast cancer who experienced a pCR in neoadjuvant chemotherapy may not received a postoperation radiotherapy because of the lowest local-recurrence rate.3.However, whether the patients of early stage breast cancer who experienced a lymph node negative status in neoadjuvant chemotherapy should received a postoperation radiotherapy or not is not clear yet,because our study is a small-scale research although our data is similar to another overseas research.4. The local-recurrence rate of lymph nodes positive group is higher,postoperation radiotherapy shows a benefit trend among these people.