Low body mass index is an independent risk factor of locoregional recurrence in women with breast cancer undergoing breast conserving therapy.
BACKGROUND
To investigate the risk factors and prognosis for locoregional recurrence (LRR) after breast conserving treatment (BCT) in women with early breast cancer.


METHODS
Women who had undergone BCT from 1998 to 2005 at Chang Gung Memorial Hospital were retrospectively reviewed. LRR was defined as the reappearance of invasive carcinoma in the treated breast and/or ipsilateral axillary lymph node (ALN). The appearance of carcinoma outside this area was defined as distant metastasis (DM). Patient characteristics, tumor characteristics, treatment modality, and follow-up clinical evaluations were analyzed. Survival was estimated by the Kaplan-Meier method and compared with the log-rank test. A multivariate model was built by the Cox regression method.


RESULTS
This study included 858 patients, and the median follow up time was 36 (range 6-193) months. Twenty seven patients developed LRR for a crude LRR rate of 3.1%. The 5-year cumulative incidence of LRR was 5.0%. The mean age of patients at the primary operation was 45 (+/-9.8) years old. Their median body mass index (BMI) was 23 (range 16-40) kg/m(2). Univariate analysis of locoregional recurrence free survival (LRRFS) revealed that age < or =40 years, a low BMI (< or =24 kg/m(2)) and omission of postoperation radiotherapy were unfavorable factors. Low BMI and young age were independent prognostic factors for LRRFS in multivariate analysis. The five-year overall survival of patients with no recurrence, LRR and DM were 97.4%, 63.2% and 41.6%, respectively (p < 0.001).


CONCLUSIONS
BCT in a young population can result in good locoregional control after careful preoperative evaluation. Women with a low BMI are at high risk of LRR.
Department of General Surgery, Chang Gung Memorial Hospital, Taipei, Chang Gung University College of Medicine, Taoyuan, Taiwan.
Chun-Han
CH
Chen
Yong-Feng
YF
Lo
Hsiu-Pei
HP
Tsai
Shih-Che
SC
Shen
Tzu-Chieh
TC
Chao
Miin-Fu
MF
Chen
Shin-Cheh
SC
Chen
D000328:Adult; D015992:Body Mass Index; D001943:Breast Neoplasms / Q000209:etiology / Q000601:surgery*; D005260:Female; D006801:Humans; D015412:Mastectomy, Segmental; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000209:etiology*; D012189:Retrospective Studies; D012307:Risk Factors