{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T04:54:19Z","timestamp":1781585659380,"version":"3.54.5"},"reference-count":23,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T00:00:00Z","timestamp":1777248000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T00:00:00Z","timestamp":1777248000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100021171","name":"Basic and Applied Basic Research Foundation of Guangdong Province","doi-asserted-by":"publisher","award":["2023A1515010086"],"award-info":[{"award-number":["2023A1515010086"]}],"id":[{"id":"10.13039\/501100021171","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2026,5]]},"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n To define the role of post\u2010mastectomy radiotherapy (PMRT) in triple\u2010negative breast cancer (TNBC), employing lymph node ratio (LNR, ratio of positive over excised lymph nodes) to offer personalized treatment strategies for this aggressively behaving cancer type.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n The study included a total of 6474 women diagnosed with T1\u20104\u2009N1\u20103\u2009M0 TNBC from 2010 to 2017 using the SEER database, all of whom underwent mastectomy. Breast cancer\u2010specific survival (BCSS) was defined as the time from diagnosis until death attributable to the breast cancer. Overall survival (OS) was defined as the time from diagnosis until death from any cause. A 1:1 propensity score matching (PSM) method was utilized to balance the baseline characteristics between the PMRT and non\u2010PMRT groups. Kaplan\u2013Meier analysis, together with the log\u2010rank test, was applied to estimate survival outcomes.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n After PSM, the PMRT group displayed better OS (HR\n OS<\/jats:sub>\n \u2009=\u20090.898, 95% CI\u2009=\u20090.819\u20130.984,\n p<\/jats:italic>\n \u2009=\u20090.021). Subgroup analyses indicated that PMRT improved BCSS outcomes in the high\u2010LNR group (HR\n BCSS<\/jats:sub>\n \u2009=\u20090.762, 95% CI\u2009=\u20090.636\u20130.913;\n p<\/jats:italic>\n \u2009=\u20090.003) rather than low\u2010 (HR\n BCSS<\/jats:sub>\n \u2009=\u20091.125, 95% CI\u2009=\u20090.938\u20131.348;\n p<\/jats:italic>\n \u2009=\u20090.203) or intermediate\u2010LNR groups (HR\n BCSS<\/jats:sub>\n \u2009=\u20090.925, 95% CI\u2009=\u20090.778\u20131.099;\n p<\/jats:italic>\n \u2009=\u20090.374). Compared with the non\u2010PMRT group, patients receiving PMRT had better OS in the intermediate\u2010LNR (HR\n OS<\/jats:sub>\n \u2009=\u20090.834, 95% CI\u2009=\u20090.715\u20130.972,\n p<\/jats:italic>\n \u2009=\u20090.021) and high\u2010LNR groups (HR\n OS<\/jats:sub>\n \u2009=\u20090.757, 95% CI\u2009=\u20090.643\u20130.893,\n p<\/jats:italic>\n \u2009=\u20090.001), whereas the difference was not significant in the low\u2010LNR group (HR\n OS<\/jats:sub>\n \u2009=\u20091.044, 95% CI\u2009=\u20090.889\u20131.226,\n p<\/jats:italic>\n \u2009=\u20090.599).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n PMRT substantially improves the survival outcomes for individuals who fall into the intermediate to high\u2010risk groups as determined by LNR, an essential prognostic factor. This helps in developing personalized PMRT treatment strategies for TNBC patients, thereby enabling precision medicine approaches.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/cam4.71882","type":"journal-article","created":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T15:44:06Z","timestamp":1777304646000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Clinical Relevance of Lymph Node Ratio for Post\u2010Mastectomy Radiotherapy in Triple\u2010Negative Breast Cancer: A Real\u2010World Analysis With Propensity Score Matching Using\n SEER<\/scp>\n Database"],"prefix":"10.1002","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7720-3063","authenticated-orcid":false,"given":"Wei\u2010Hong","family":"Zheng","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology Sun Yat\u2010Sen University Cancer Center, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy Guangzhou People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jia\u2010Yuan","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Sun Yat\u2010Sen University Cancer Center, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy Guangzhou People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jia","family":"Kou","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Sun Yat\u2010Sen University Cancer Center, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy Guangzhou People's Republic of China"},{"name":"Department of Anesthesiology Sun Yat\u2010Sen University Cancer Center, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy Guangzhou People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feng\u2010Yan","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Sun Yat\u2010Sen University Cancer Center, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy Guangzhou People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guan\u2010Qiao","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Breast Surgery Hainan General Hospital (Hainan Affiliated Hospital of Medical University) Haikou People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0556-2614","authenticated-orcid":false,"given":"San\u2010Gang","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Xiamen Cancer Center, Xiamen Key Laboratory of Radiation Oncology, the First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University Xiamen People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhen\u2010Yu","family":"He","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Sun Yat\u2010Sen University Cancer Center, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy Guangzhou People's Republic of China"},{"name":"Department of Radiation Oncology Xiamen Cancer Center, Xiamen Key Laboratory of Radiation Oncology, the First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University Xiamen People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,27]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21834"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)32381-3"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(14)71104-0"},{"key":"e_1_2_12_5_1","unstructured":"NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) Breast Cancer Version 3.2024 June 17 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