Prognostic factors affecting locoregional recurrence in patients with stage IIIB noninflammatory breast cancer.
BACKGROUND
The aim of the present study was to identify the clinicopathological factors affecting locoregional recurrence (LRR) in patients with clinical stage IIIB noninflammatory breast cancer (NIBC).


METHODS
The records of 120 stage IIIB NIBC patients treated with neoadjuvant chemotherapy (NAC) and then modified radical mastectomy followed by radiotherapy were evaluated. In this retrospective cohort, the effects of age, menopausal status, clinical tumor size, clinical response to NAC, pathological axillary status, number of positive axillary lymph nodes, pathological response to NAC, grade, lymphovascular invasion, estrogen receptor status, progesterone receptor status, Her-2-neu status, and p53 status on LRR were evaluated by univariate and multivariate analyses.


RESULTS
The clinical response rate of 120 patients was 79.2% (17.5% complete and 61.7% partial), with a complete pathological response rate of 12.5%. The median follow-up was 28 months (range: 10-74 months). The LRR rate was 13.3%. Based on the univariate analysis, the clinical tumor size, clinical response rate, pathological axillary status, four or more positive axillary lymph nodes, lymphovascular invasion, and estrogen receptor status were factors that significantly affected LRR. In the multivariate analysis, however, only the clinical response rate and the number of positive axillary lymph nodes were found to be statistically significant independent factors.


CONCLUSIONS
Effective local control of disease can be achieved in patients with stage IIIB NIBC using a combination of NAC, surgery, and radiotherapy. However, a worse clinical response after chemotherapy and four or more positive axillary lymph nodes affect LRR negatively in these patients.
Gülben
Kaptan
K
Department of Surgery, Ankara Oncology Training and Research Hospital, Urankent sitesi, C-9 block, No:33, 06200, Demetevler, 06200, Ankara, Turkey. kgulben@yahoo.com.
Berberoğlu
Uğur
U
Department of Surgery, Ankara Oncology Training and Research Hospital, Urankent sitesi, C-9 block, No:33, 06200, Demetevler, 06200, Ankara, Turkey.
Cengiz
Aziz
A
Department of Surgery, Ankara Oncology Training and Research Hospital, Urankent sitesi, C-9 block, No:33, 06200, Demetevler, 06200, Ankara, Turkey.
Altınyollar
Hüseyin
H
Department of Surgery, Ankara Oncology Training and Research Hospital, Urankent sitesi, C-9 block, No:33, 06200, Demetevler, 06200, Ankara, Turkey.
D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000378:metabolism; D001706:Biopsy; D001943:Breast Neoplasms / Q000175:diagnosis / Q000378:metabolism / Q000401:mortality / Q000473:pathology* / Q000628:therapy*; D002277:Carcinoma / Q000175:diagnosis / Q000378:metabolism / Q000401:mortality / Q000473:pathology* / Q000628:therapy*; D017024:Chemotherapy, Adjuvant; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015411:Mastectomy, Modified Radical; D008875:Middle Aged; D015999:Multivariate Analysis; D020360:Neoadjuvant Therapy / Q000379:methods; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control*; D009367:Neoplasm Staging; D011379:Prognosis; D011878:Radiotherapy / Q000379:methods; D018714:Radiotherapy, Adjuvant; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000378:metabolism; D012189:Retrospective Studies; D016159:Tumor Suppressor Protein p53 / Q000378:metabolism
D014408:Biomarkers, Tumor; D018719:Erb-b2 Receptor Tyrosine Kinases; D016159:Tumor Suppressor Protein p53