Radiotherapy and Chemotherapy in High-Risk Breast Cancer

Abstract

The study by Overgaard et al. (Oct. 2 issue)¹ was designed to address the capacity of radiation therapy after mastectomy to reduce the frequency of distant relapse or to delay it significantly in women with stage I or II breast cancer, but the inclusion of patients with stage IIIA and stage IIIB disease creates interpretive difficulties. There are no data concerning the number and distribution of patients with tumor stage T4, nor is it clear how many patients with T3 disease were classified as having N0 (stage II) or N1 (stage III) nodal involvement. Table 1 of the article by Overgaard et al. indicates that there were significantly more patients with tumors more than 5 cm in size in the group treated with chemotherapy alone (n = 135) than in the chemotherapy–radiation group (n = 99), with a P value of 0.03. How many patients with stage IIIA or IIIB disease were there in each treatment group? The need for irradiation after mastectomy for local–regional control in patients with stage III breast cancer is established. Was such irradiation associated with a significant survival advantage among the women in each treatment group with stage II disease?