title: Factors predictive of mortality in a cohort of women surgically treated for breast cancer from 1997 to 2014.
abstract: OBJECTIVE
  To determine whether previously reported factors predictive of breast cancer mortality are effectively linked with mortality, particularly breast-cancer-specific mortality.
  
  
  METHODS
  In a prospective study, clinical, surgical, and follow-up data were assessed for consecutive patients with breast cancer who underwent surgery between 1997 and 2014 at two centers in Barcelona, Spain. Predictors of mortality were assessed by multivariate analysis.
  
  
  RESULTS
  Overall, 2134 patients were treated for 2206 breast tumors. Overall mortality was 15.0% (n=319), and breast-cancer-specific mortality was 9.0% (n=191). On multivariate analysis, the most significant factors associated with breast-cancer-specific mortality were clinical stage, inmunohistochemical profile, locoregional relapse, and lymphovascular invasion (all P<0.001). Age at onset, participation in the mass-screening program, histologic grade, and multicentricity were not significant. Patients with three or more positive axillary nodes sustained a specific mortality significantly higher than did node-negative patients or those with fewer than three positive nodes.
  
  
  CONCLUSIONS
  Factors predictive of breast cancer mortality were clinical stage, locoregional relapse, molecular classification, lymphovascular invasion, and neoadjuvant chemotherapy. As a single factor, nodal disease becomes relevant only when three or more lymph nodes are involved.
authors.affiliation: Breast Unit, Department of Gynecology, University Hospital of Mútua Terrassa, Research Foundation Mútua Terrassa, University of Barcelona, Terrassa, Spain. Electronic address: drgarciafdez@hotmail.com.
authors.forename: Antonio
authors.initials: A
authors.lastname: García-Fernández
authors.affiliation: Breast Unit, Department of Gynecology, University Hospital of Mútua Terrassa, Research Foundation Mútua Terrassa, University of Barcelona, Terrassa, Spain.
authors.forename: Israel
authors.initials: I
authors.lastname: Barco
authors.affiliation: Nuclear Medicine Department, University Hospital of Mútua Terrassa, Research Foundation Mútua Terrassa, University of Barcelona, Terrassa, Spain.
authors.forename: Manel
authors.initials: M
authors.lastname: Fraile
authors.affiliation: Breast Unit, Department of Gynecology, Hospital of Terrassa, Health Consortium of Terrassa, Terrassa, Spain.
authors.forename: José M
authors.initials: JM
authors.lastname: Lain
authors.affiliation: Department of Gynecology, University Hospital of Mútua Terrassa, Research Foundation Mútua Terrassa, University of Barcelona, Terrassa, Spain.
authors.forename: Ana
authors.initials: A
authors.lastname: Carmona
authors.affiliation: Department of Hemato-Oncology, University Hospital of Mútua Terrassa, Research Foundation Mútua Terrassa, University of Barcelona, Terrassa, Spain.
authors.forename: Sonia
authors.initials: S
authors.lastname: Gonzalez
authors.affiliation: Department of Gynecology, University Hospital of Mútua Terrassa, Research Foundation Mútua Terrassa, University of Barcelona, Terrassa, Spain.
authors.forename: Antoni
authors.initials: A
authors.lastname: Pessarrodona
authors.affiliation: Research Unit, Research Foundation Mútua Terrassa, University of Barcelona, Terrassa, Spain; Laboratory of Toxicology, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: Nuria
authors.initials: N
authors.lastname: Giménez
authors.affiliation: International University of Catalonia, Barcelona, Spain.
authors.forename: Marc
authors.initials: M
authors.lastname: García-Font
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000401:mortality* / Q000473:pathology* / Q000601:surgery* / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis; D008403:Mass Screening; D008875:Middle Aged; D015999:Multivariate Analysis; D020360:Neoadjuvant Therapy / Q000379:methods; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology* / Q000473:pathology; D009367:Neoplasm Staging; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D013030:Spain; D015996:Survival Rate; D055815:Young Adult
keywords: Breast cancer; Mass screening; Mortality; Survival