Prognostic factors in stage-i (T1N0) breast carcinoma patients: who needs adjuvant systemic treatment?
There is no consensus about the need of adjuvant therapy in T(1)N(0) breast carcinoma patients. To select a subgroup of these patients who may benefit from adjuvant systemic therapy, prognostic factor analyses were carried out using chi-square test and Cox regression analysis in 187 patients data in this retrospective study. Primary endpoint was distant metastasis (DM). The multivariate Cox analysis showed that age group (<or=35 years vs >35 years, p=0.01; Hazard Ratio [HR], 15.4; 95% Confidence Interval [CI], 1.8-133.0), tumor size (>1 cm vs <or=1 cm, p=0.002; HR,3.5; CI:1.2-13.4) and LVI (yes vs no, p=0.002; HR,34.7; CI:3.6-326.0) were strongly associated with DM. From this analysis, a risk estimation model for DM was constructed. Whereas patients at low risk had a 96% distant metastasis-free survival, this rate for those at high risk had a 37% (p<0.00001). According to the proposed model including age, tumor size and LVI, the patients at high risk might benefit from adjuvant systemic therapy.
Yildirim
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Ankara Oncology Training and Research Hospital, Department of Surgery, Ankara, Turkey. yildirimemin@yahoo.com
Berberoglu
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D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000188:drug therapy / Q000517:prevention & control*; D018270:Carcinoma, Ductal, Breast / Q000175:diagnosis / Q000188:drug therapy / Q000517:prevention & control; D018275:Carcinoma, Lobular / Q000175:diagnosis / Q000188:drug therapy / Q000517:prevention & control; D017024:Chemotherapy, Adjuvant; D005260:Female; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D011960:Receptors, Estrogen / Q000378:metabolism; D011980:Receptors, Progesterone / Q000378:metabolism; D012189:Retrospective Studies; D018570:Risk Assessment