Axillary Irradiation with high tangent fields for clinically node-negative breast cancer: Can 3-D conformal radiotherapy with a field-in-field technique better control the axilla?

Naoko Sanuki, Atsuya Takeda, Atsushi Amemiya, Toru Ofuchi, Masato Ono, Haruki Ogata, Ryo Yamagami, Jun Hatayama, Takahisa Eriguchi, Etsuo Kunieda

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background: The target volume for postoperative breast irradiation is the remaining breast tissue, and the axillary region is not an intentional target volume. Patients and Methods: Between 2001 and 2009, eligible women with pT1-2cN0/pN0(sn) breast cancer underwent breast-conserving therapy without axillary dissection. Treatment outcomes between 2 radiotherapy planning groups, high tangent fields with 2-dimensional (2-D) simulation-based planning and 3-dimensional (3-D) computed tomography-based planning with a field-in-field technique, were compared. The correlating factors for axillary failure were also calculated. Results: In total, 678 patients were eligible. As of May 2009, the median follow-up times for the 2-D (n = 346) and 3-D (n = 332) groups were 94 and 52 months, respectively. Patient characteristics were balanced, except for a younger population in the 2-D group and more lymphovascular invasion in the 3-D group. On multivariate analysis, 2-D planning was the only risk factor for axillary failure. In the 2-D and 3-D groups, the 5-year cumulative incidences of axillary failure were 8 (3.1%) and 1 (0.3%) (log-rank p = 0.009), respectively. The respective 5-year overall survival rates were 97.4 and 98.4% (p = 0.4). Conclusion: High tangent irradiation with 3-D planning improved axillary control compared to that with 2-D planning, suggesting that optimizing axillary dose distribution may impact outcomes.

Original languageEnglish
Pages (from-to)362-367
Number of pages6
JournalBreast Care
Volume8
Issue number5
DOIs
Publication statusPublished - 2013

Keywords

  • Breast cancer
  • Conformal radiotherapy
  • Sentinel lymph node biopsy

ASJC Scopus subject areas

  • Surgery
  • Oncology

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    Sanuki, N., Takeda, A., Amemiya, A., Ofuchi, T., Ono, M., Ogata, H., Yamagami, R., Hatayama, J., Eriguchi, T., & Kunieda, E. (2013). Axillary Irradiation with high tangent fields for clinically node-negative breast cancer: Can 3-D conformal radiotherapy with a field-in-field technique better control the axilla? Breast Care, 8(5), 362-367. https://doi.org/10.1159/000355708