title: Prognostic factors after conservative surgery and radiation therapy for early stage breast cancer.
abstract: A retrospective review was conducted of all early-stage breast cancer patients treated with breast-conservation surgery plus radiation therapy (BCS/RT) to determine mortality and recurrence rates and to evaluate prognostic factors for these outcomes. Between 1982 and 1988, 121 patients with stages I and II breast cancer were treated with BCS/RT at our institution. Most of the patients (83%) had re-excision of the initial biopsy site and at final surgical evaluation, only 4 patients had positive margins (3.2%). Median follow-up was 89.7 months. Cox proportional hazards regression models were used to select prognostic factors significant for breast cancer-specific mortality, overall disease recurrence, and local recurrence. Breast cancer survival rates were 92% at 5 years and 83% at 10 years. Prognostic factors predicting breast cancer mortality included positive lymph nodes (relative risk=.9; 95% confidence interval, 1.2,12.2) and a higher grade (relative risk=1.9; 95% confidence interval, 1.1,3.3). For disease recurrence, prognostic factors included positive nodes (relative risk=2.6; 95% confidence interval, 1.2, 5.5), and a negative progesterone-receptor status (relative risk=0.3; 95% confidence interval, 0.2, 0.8). Local recurrence rates were 2.5% at 5 years and 14% at 10 years. No prognostic factors were significant for local recurrence; however, most patients had negative margins after surgery.
authors.affiliation: Department of Oncology Research, Institute for Research and Education, Methodist Hospital Cancer Center, HealthSystem Minnesota, Minneapolis 55416, USA.
authors.forename: K K
authors.initials: KK
authors.lastname: Swenson
authors.forename: L
authors.initials: L
authors.lastname: Decher
authors.forename: R
authors.initials: R
authors.lastname: Haselow
authors.forename: J B
authors.initials: JB
authors.lastname: Farrell
authors.forename: P W
authors.initials: PW
authors.lastname: Sperduto
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008875:Middle Aged; D009362:Neoplasm Metastasis; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D016019:Survival Analysis