Local recurrence in breast carcinoma patients with T(1-2) and 1-3 positive nodes: indications for radiotherapy.
OBJECTIVE
To investigate the relationship between local recurrence (LR) and distant recurrence (DR) and to determine a subgroup of patients who could benefit from radiotherapy among breast carcinoma patients with T(1-2) and N(1a).


METHODS
Univariate and multivariate Cox regression analyses were carried out in the retrospective data of 326 eligible patients.


RESULTS
Fourteen (4.3%) patients had LR and 46 (14.1%) patients suffered DR, in their follow-up periods. The multivariate time-dependent Cox model for DR showed that ratio of positive nodes (PN) (p=0.004; hazard ratio (HR), 1.05; 95% confidence interval (CI), 1.02-1.09) and LR (p=0.05; HR, dependent on time) were strongly associated with DR. In the multivariate Cox analysis for LR, age (<or=35 years vs >35 years; p<0.0001; HR, 6.8; CI, 2.3-19.9), lymphatic vascular invasion (LVI) (yes vs no; p=0.03; HR, 3.3; CI, 1.2-9.8), and a ratio of PN (>15% vs <or=15%; p<0.0001; HR, 13.0; CI, 3.9-42.0) were the most important prognostic factors. Whereas patients with 2 or 3 risk factors were accepted as the high risk group for LR, those with no or 1 risk factor were considered as the low risk group. These groups had a 23% LR rate and a 2.7% LR rate, respectively (p<0.0001).


CONCLUSIONS
This report confirmed the importance of local recurrence for distant recurrence. Age, ratio of PN and LVI were the most important prognostic factors for LR. The T(1-2) and N(1a) patients who had 2 or 3 risk factors might benefit from radiotherapy.
Yildirim
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E
Ankara Oncology Training and Research Hospital, Department of Surgery, Konutkent-2, A-4 Blok 44, Cayyolu, 06530, Ankara, Turkey. yildirimemin@yahoo.com
Berberoglu
U
U
D000328:Adult; D000368:Aged; D001365:Axilla; D001943:Breast Neoplasms / Q000473:pathology* / Q000532:radiotherapy; D018270:Carcinoma, Ductal, Breast / Q000532:radiotherapy / Q000556:secondary*; D018275:Carcinoma, Lobular / Q000532:radiotherapy / Q000556:secondary*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology* / Q000532:radiotherapy*; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies