TITLE:
Mastectomy Scar Boost Results in Low Risk of Locoregional Recurrence in the Setting of Close or Involved Surgical Margins
AUTHORS:
Laura Johnson, Natalie Lichter, Mamie Hextall, Patricia L. Watkins, Tarek A. Dufan, John M. Watkins
KEYWORDS:
Breast Neoplasms; Mastectomy; Adjuvant Therapy; Radiotherapy
JOURNAL NAME:
Journal of Cancer Therapy,
Vol.5 No.2,
February
10,
2014
ABSTRACT:
Background: Several Phase III randomized trials have demonstrated
improved local control and survival for post-mastectomy radiotherapy in
patients with high-risk pathologic features. Close or involved surgical margins
were not included as high-risk in these protocols, but have been associated
with increased risk of local failure; however, the impact of a boost dose
following chestwall radiotherapy in this setting remains to be determined.
Methods: Retrospective single-institution outcomes analysis for patients with
close or involved surgical margins treated with post-operative radiotherapy is followed by a boost. Results: Between 2003 and 2011, 34 patients were
identified for inclusion in the present study. The median chestwall dose was
5040 cGy (range 5000 - 5040) and median
boost dose was 1080 cGy (900 - 1620). At a median
follow-up of 38.4 months (10.2 - 115.6; with 29%
more than 5 years), 28 patients were alive without evidence of recurrence, 3
were alive with recurrent disease (1 chestwall), and 3 had died (none with recurrent
disease). The 3-year local control, disease-free survival, and overall
survivals were 96.9%, 93.9%, and 93.1%, respectively. Conclusion: Chestwall radiotherapy plus boost
results in low risk of early locoregional recurrence for women with close or
involved surgical margin(s) at mastectomy. Further investigation of PMRT with
or without boost in this setting is warranted.