Can a subgroup of node-negative breast carcinoma patients with T1-2 tumor who may benefit from postmastectomy radiotherapy be identified?
OBJECTIVE
To determine a subgroup of T1-2N0 breast carcinoma patients at high risk for local recurrence.


METHODS
In this retrospective study, univariate and multivariate prognostic factor analyses for local recurrence and distant recurrence were carried out in 502 patients.


RESULTS
During the median observation time of 77 months (range, 24-191 months), 14 patients (2.8%) had local recurrence and 55 (11.0%) had distant recurrence. Tumor size (continuous, p = 0.03; hazard ratio [HR] 1.2; 95% confidence interval [CI], 1.1-1.7), grade (p = 0.01; HR, 2.4; 95% CI, 1.2-5.0), lymphatic vascular invasion (LVI) (p = 0.01; HR, 10.0; 95% CI, 2.4-17.3), estrogen receptor status (p = 0.01; HR, 6.3; 95% CI, 2.0-23.0) and cErbB2 status (p = 0.01; HR, 10.0; 95% CI 1.8-87.5) were strongly associated with distant recurrence. Tumor size (< or =2 cm vs. >2 cm; p = 0.05; HR, 5.4; 95% CI, 1.2-28.0) and LVI (p = 0.004; HR, 9.0; 95% CI, 2.0-41.0) in patients aged < or =40 years, and tumor size (< or =3 cm vs. >3 cm; p = 0.05; HR 8.6; 95% CI 1.3-75.0), LVI (p = 0.007; HR, 18.0; 95% CI, 2.1-153.0), and grade (p = 0.05; HR, 7.0; 95% CI, 1.2-63.0) in patients aged >40 years were the most important predictive factors for local recurrence.


CONCLUSIONS
Among breast carcinoma patients, young patients with tumor size >2 cm and LVI and older patients with tumor size >3 cm, LVI, and high-grade tumor had a high risk of local recurrence.
Yildirim
Emin
E
Department of Surgery, Ankara Oncology Training and Research Hospital, Ankara, Turkey.
Berberoglu
Ugur
U
D000328:Adult; D000367:Age Factors; D000368:Aged; D000704:Analysis of Variance; D001365:Axilla; D001943:Breast Neoplasms / Q000473:pathology / Q000517:prevention & control / Q000532:radiotherapy* / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D015411:Mastectomy, Modified Radical; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control*; D009367:Neoplasm Staging; D012372:ROC Curve; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D018570:Risk Assessment