CWI has no impact on overall survival at 10 years among patients with intermediate-risk breast cancer
By Elana Gotkine HealthDay Reporter
MONDAY, Dec. 16, 2024 (HealthDay News) — For patients with intermediate-risk breast cancer, chest wall irradiation (CWI) after mastectomy does not influence 10-year overall survival, according to a study presented at the annual San Antonio Breast Cancer Symposium, held from Dec. 10 to 13 in San Antonio.
Ian Kunkler, M.B., B.Chir., from the University of Edinburgh in the United Kingdom, and colleagues examined the impact of adjuvant CWI following mastectomy and axillary surgical staging with operable breast cancer at intermediate-risk of locoregional recurrence. Data were included for 1,607 patients: 808 were randomly assigned to receive CWI after mastectomy and 799 were randomly assigned to no CWI after mastectomy; all participants received guideline-concordant axillary node clearance and systemic treatments.
The researchers found that CWI had no impact on overall survival at 10 years and had no impact on overall survival in node-negative (pN0) patients versus those with one to three positive axillary lymph nodes (pN1). Twenty-nine chest wall recurrences occurred, with chest wall recurrence-free survival probabilities of 98.8 and 97.1 percent for the CWI and no-CWI groups, respectively, at a median follow-up of 9.6 years. Chest wall recurrence was slightly reduced with CWI (hazard ratio, 0.45). No evidence of a significant differential treatment effect was seen for the pN1 and pN0 groups.
“This study demonstrates that CWI after a mastectomy has no influence on 10-year overall survival for patients with intermediate-risk breast cancer,” Kunkler said in a statement. “The results are important considerations for shared decision-making conversations between patients and clinicians, as many patients eligible for postmastectomy CWI may not require the treatment.”
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