title: Clinical and pathologic risk factors of tumor recurrence in patients with node-negative early breast cancer after mastectomy.
abstract: OBJECTIVE
  Patients with node-negative breast cancer (NNBC) usually have a good prognosis, but tumor recurrence still compromises survival. In this study, we sought to identify clinical and pathologic factors that predict recurrence.
  
  
  METHODS
  A total of 716 patients who were proved with pT1-2N0M0 breast cancer between 2005 and 2009 were enrolled in this study.
  
  
  RESULTS
  Forty-seven of the 716 patients developed tumor recurrence during the 47.0 months of median follow-up. The significant risk factors of recurrence were lymphovascular invasion (LVI) (hazard ratio [HR] = 4.60, 95% CI. 2.32-9.10) and Nottingham grade 3 (HR = 4.99, 95% CI. 1.06-23.48); adjuvant radiotherapy (HR = 0.35, 95% CI. 0.14-0.92) prevented tumor recurrence. Furthermore, we investigate the therapeutic impact of adjuvant chemotherapy and radiotherapy on patients with LVI and Nottingham grade 3. The adverse effect of LVI and grade 3 can be abrogated by adjuvant radiotherapy in recurrence-free survival (RFS) (LVI((+)) radiotherapy((+)) , no recurrence; grade 3((+)) radiotherapy((+)) , HR = 0.82, 95% CI. 0.18-3.70). However, adjuvant chemotherapy did not.
  
  
  CONCLUSIONS
  LVI and Nottingham grade 3 were the independent risk factors predicting tumor recurrence for patients with NNBC. Adjuvant radiotherapy might be considered in NNBC patients with these unfavorable factors to improve the RFS.
authors.affiliation: Graduate Institute of Clinical Medicine Science, China Medical University, Taichung, Taiwan; Department of Medical Genetics, China Medical University Hospital, Taichung, Taiwan; Division of Hematology and Oncology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan; Department of Medical Genetics, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Po-Han
authors.initials: PH
authors.lastname: Lin
authors.forename: Ming-Hsin
authors.initials: MH
authors.lastname: Yeh
authors.forename: Liang-Chih
authors.initials: LC
authors.lastname: Liu
authors.forename: Chih-Jung
authors.initials: CJ
authors.lastname: Chen
authors.forename: Yu-Chu
authors.initials: YC
authors.lastname: Tsui
authors.forename: Chen-Hsien
authors.initials: CH
authors.lastname: Su
authors.forename: Hwei-Chung
authors.initials: HC
authors.lastname: Wang
authors.forename: Ji-An
authors.initials: JA
authors.lastname: Liang
authors.forename: Hui-Wen
authors.initials: HW
authors.lastname: Chang
authors.forename: Hsiao-Su
authors.initials: HS
authors.lastname: Wu
authors.forename: Su-Peng
authors.initials: SP
authors.lastname: Yeh
authors.forename: Long-Yuan
authors.initials: LY
authors.lastname: Li
authors.forename: Chang-Fang
authors.initials: CF
authors.lastname: Chiu
mesh_terms: D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis; D001943:Breast Neoplasms / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008198:Lymph Nodes / Q000473:pathology; D015411:Mastectomy, Modified Radical; D008875:Middle Aged; D060787:Neoplasm Grading; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis* / Q000473:pathology; D009367:Neoplasm Staging; D016017:Odds Ratio; D016016:Proportional Hazards Models; D018714:Radiotherapy, Adjuvant; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000032:analysis; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D064726:Triple Negative Breast Neoplasms
chemical_list: D014408:Biomarkers, Tumor; D018719:Erb-b2 Receptor Tyrosine Kinases; C508053:ERBB2 protein, human
keywords: breast cancer; grade; lymphovascular invasion; node-negative; radiotherapy