Suggestion for the Omission of Post-mastectomy Chest Wall Radiation Therapy in Patients who Underwent Skin-sparing/Nipple-sparing Mastectomy

Nalee Kim, Won Park , Won Kyung Cho et al.
Suggestion for the Omission of Post-mastectomy Chest Wall Radiation Therapy in Patients who Underwent Skin-sparing/Nipple-sparing Mastectomy
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Aim: Both skin-sparing mastectomy (SSM) and nipple-sparing mastectomy (NSM) have been widely adopted. Although postmastectomy radiation therapy (PMRT) can improve clinical outcomes, it can worsen cosmesis following reconstruction. Therefore, identifying risk factors of ipsilateral breast tumor recurrence (IBTR) could help de-escalate PMRT after NSM/SSM in patients with pT1-2 disease.

Methods: We retrospectively reviewed patients treated with SSM (N = 400) and NSM (N = 156) in patients with pT1-2N0-1 disease between 2009 and 2016. Seventy-four patients received PMRT with 50-50.4 Gy in 25-28 fractions. The Cox proportional hazards model was used to analyze the prognostic factors of IBTR.

Conclusion: We identified risk factors (age and LVI) related to IBTR following upfront SSM/NSM with pT1-2 disease. As a hypothesis-generating study, de-escalation of PMRT by omitting chest wall irradiation in selective patients could improve reconstruction-related complications without compromising oncologic outcomes.

Read the full article here: https://pubmed.ncbi.nlm.nih.gov/36179501/ 

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