Breast (Edinburgh, Scotland) · 2025
Nodal response to neoadjuvant therapy predicts prognosis of breast cancer patients with clinically positive internal mammary nodes.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Xu Zhe, Cao Lu, Qi Wei-Xiang, Cai Gang, Ou Dan, Xu Cheng, Cai Rong, Li Shu-Yan, Chen Jia-Yi
Аннотация
PURPOSE: To evaluate survival outcomes and prognostic factors in breast cancer patients with clinically positive internal mammary lymph nodes (cIMN+) after combined-modality therapy, and to identify indicators for internal mammary nodal boost irradiation.
METHOD: Consecutive cIMN + patients between January 2010 and April 2023 were retrospectively reviewed. According to nodal response to neoadjuvant therapy (NAT), patients were divided into three groups: no IMN clinical complete response (cCR) (Group A), IMN cCR without ALN pathological complete response (pCR) (Group B), both IMN cCR and ALN pCR (Group C).
RESULTS: Among 141 eligible patients (median follow-up 49.5 months), the 5-year rates for overall survival (OS) and recurrence-free survival (RFS) were 85.7 % and 76.7 %, respectively. Multivariable analysis confirmed ALN pCR and IMN cCR as independent favorable prognostic factors. Patients in group C exhibited superior 5-year OS (97.4 % vs. 88.9 % vs. 71.0 %, p = 0.007) and RFS (93.9 % vs. 71.8 % vs. 61.4 %, p < 0.001), along with the lowest rate of distant metastasis (5.8 % vs. 22.7 % vs. 33.3 %, p = 0.003) compared to Groups B and A. In Group A patients, higher cumulative radiation dose (≥60 Gy) to IMN significantly improved both 5-year OS (71.0 % vs. 93.5 %, p = 0.009) and 5-year RFS (33.3 % vs. 69.3 %, p = 0.031).
CONCLUSION: The dual achievement of IMN cCR and ALN pCR after NAT predicts exceptional outcomes. For patients with persistent IMN involvement after NAT, IMN dose escalation to ≥60 Gy significantly improved OS and RFS. These findings support individualized radiotherapy strategies based on nodal response.
METHOD: Consecutive cIMN + patients between January 2010 and April 2023 were retrospectively reviewed. According to nodal response to neoadjuvant therapy (NAT), patients were divided into three groups: no IMN clinical complete response (cCR) (Group A), IMN cCR without ALN pathological complete response (pCR) (Group B), both IMN cCR and ALN pCR (Group C).
RESULTS: Among 141 eligible patients (median follow-up 49.5 months), the 5-year rates for overall survival (OS) and recurrence-free survival (RFS) were 85.7 % and 76.7 %, respectively. Multivariable analysis confirmed ALN pCR and IMN cCR as independent favorable prognostic factors. Patients in group C exhibited superior 5-year OS (97.4 % vs. 88.9 % vs. 71.0 %, p = 0.007) and RFS (93.9 % vs. 71.8 % vs. 61.4 %, p < 0.001), along with the lowest rate of distant metastasis (5.8 % vs. 22.7 % vs. 33.3 %, p = 0.003) compared to Groups B and A. In Group A patients, higher cumulative radiation dose (≥60 Gy) to IMN significantly improved both 5-year OS (71.0 % vs. 93.5 %, p = 0.009) and 5-year RFS (33.3 % vs. 69.3 %, p = 0.031).
CONCLUSION: The dual achievement of IMN cCR and ALN pCR after NAT predicts exceptional outcomes. For patients with persistent IMN involvement after NAT, IMN dose escalation to ≥60 Gy significantly improved OS and RFS. These findings support individualized radiotherapy strategies based on nodal response.