title: Recurrence patterns in a prospective study of patients with stage II breast cancer treated with endocrine-chemotherapy.
abstract: Local-regional versus distant recurrence patterns were investigated for 311 patients with stage II node-positive breast cancer who were part of an endocrine-chemotherapy adjuvant breast cancer trial. After mastectomy patients were randomized to receive either cytoxan, methotrexate, and 5-fluorouracil (CMF) (1 year) or CMF with tamoxifen (1 year) with or without bacillus Calmette-Guérin (BCG). With a median follow-up of 92.1 months, 55.3% of the patients had recurrences. The first site of recurrence was local-regional for 31.4% of patients and distant for 68.6%. This pattern of first recurrence was not associated with treatment groups, menopausal status, race, estrogen receptor value, number of positive lymph nodes, or tumour diameter. Although patients with a first local-regional recurrence had a better overall prognosis compared with those with a first distant recurrence, 52.2% of those patients with an initial local-regional recurrence developed a distant recurrence within 12 months. Among patients who had a recurrence, 48.3% had a local-regional recurrence at some time during their follow-up. Conclusions from this study are (1) patterns of recurrence were not affected by the addition of antiestrogen therapy to chemotherapy; (2) for the variables tested, including number of positive nodes and tumor diameter, no association with recurrence patterns was found; and (3) most patients (52.2%) with a first local-regional recurrence will develop a distant recurrence within 1 year.
authors.affiliation: Department of Surgery, Case Western Reserve University, Cleveland, Ohio.
authors.forename: J P
authors.initials: JP
authors.lastname: Crowe
authors.forename: N H
authors.initials: NH
authors.lastname: Gordon
authors.forename: A R
authors.initials: AR
authors.lastname: Antunez
authors.forename: C A
authors.initials: CA
authors.lastname: Hubay
authors.forename: O H
authors.initials: OH
authors.lastname: Pearson
authors.forename: J S
authors.initials: JS
authors.lastname: Marshall
authors.forename: W L
authors.initials: WL
authors.lastname: McGuire
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001500:BCG Vaccine / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000473:pathology* / Q000628:therapy; D002986:Clinical Trials as Topic; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000008:administration & dosage; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D008727:Methotrexate / Q000008:administration & dosage; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local; D011379:Prognosis; D011446:Prospective Studies; D011897:Random Allocation; D013629:Tamoxifen / Q000008:administration & dosage
chemical_list: D001500:BCG Vaccine; D013629:Tamoxifen; D003520:Cyclophosphamide; D005472:Fluorouracil; D008727:Methotrexate