title: Clinical features and prognostic factors of early breast cancer at a major cancer center in North India.
abstract: BACKGROUND
  Data on the clinical profile of early breast cancer (EBC) from India is scant. Due to differences in genetics, environment, lifestyle, socio-demographic structure and ethnicity, the presentation and behavior of breast cancer in India may be different.
  
  
  OBJECTIVE
  To analyze the clinical presentation and outcome of EBC patients.
  
  
  METHODS
  A single center retrospective study.
  
  
  METHODS
  Data from 487 EBC patients registered and treated at our institute from 1993 through 1999 were analyzed. Cox's multivariate regression test was used to determine prognostic factors for overall and disease-free survival (OS & DFS).
  
  
  RESULTS
  The median age was 47 years and 49.7% patients were pre-menopausal. Ninety-six per cent patients presented with a lump. Stages I, IIa, and IIb comprised 7.8%, 38.8%, and 47.6% respectively. Only 11.3% patients opted for breast-conserving surgery (BCS) while the remaining 88.7% underwent modified radical mastectomy (MRM). Adjuvant chemotherapy was administered to 275 (56.5%), and radiotherapy to 146 (29.9%). Estrogen receptor status was known in 173, of whom 93 (53.7%) were positive. Most patients were prescribed Tamoxifen for 5 years. At a median follow-up of 48 months, 126 (25.9%) patients had relapsed (systemic 107, loco-regional 19) and 94 (19.3%) had died. Five-year DFS and OS were 73% and 78%, respectively. On multivariate analysis, four positive nodes adversely influenced survival (P< 0.01).
  
  
  CONCLUSIONS
  The median age at presentation was 47 years, significantly lower than most Western figures. The majority (86.4%) had a lump size > two cm. BCS was done in only 11% and the rest underwent MRM. Nodal involvement was the significant prognostic factor.
authors.affiliation: Department of Medical Oncology, Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi 110029, India. vinodraina@hotmail.com
authors.forename: Vinod
authors.initials: V
authors.lastname: Raina
authors.forename: Manisha
authors.initials: M
authors.lastname: Bhutani
authors.forename: Rajeev
authors.initials: R
authors.lastname: Bedi
authors.forename: Atul
authors.initials: A
authors.lastname: Sharma
authors.forename: Suryanarayana V
authors.initials: SV
authors.lastname: Deo
authors.forename: Nootan K
authors.initials: NK
authors.lastname: Shukla
authors.forename: Bidhu Kalyan
authors.initials: BK
authors.lastname: Mohanti
authors.forename: Goura K
authors.initials: GK
authors.lastname: Rath
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality / Q000473:pathology / Q000628:therapy; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D008499:Medical Records; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000401:mortality / Q000473:pathology / Q000628:therapy; D009367:Neoplasm Staging; D009376:Neoplasms, Hormone-Dependent / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000401:mortality / Q000473:pathology / Q000628:therapy; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis