PROGNOSTIC FACTORS FOR LOCAL RECURRENCE IN THE CONSERVATIVELY TREATED BREAST-CANCER PATIENT - A CAUTIOUS INTERPRETATION OF THE DATA

被引:79
作者
HAFFTY, BG
FISCHER, D
ROSE, M
BEINFIELD, M
MCKHANN, C
机构
[1] YALE UNIV, SCH MED, DEPT SURG, NEW HAVEN, CT 06510 USA
[2] NORWALK HOSP, DEPT SURG, NORWALK, CT 06856 USA
关键词
D O I
10.1200/JCO.1991.9.6.997
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Between 1962 and 1984, a total of 433 patients were treated at Yale-New Haven Hospital with conservative surgery and radiation therapy (CS + RT) to the intact breast. As of January 1990, with a minimum assessable follow-up of 5 years and a median follow-up of 8.21 years, there have been a total of 50 breast recurrences resulting in a 5-year actuarial breast recurrence rate of 8%. Of all clinical factors tested, young age was the most significant prognostic factor for local recurrence (P < .03). In addition, patients with pathologically involved lymph nodes were noted to have a lower local recurrence rate than patients with pathologically negative axillae (P < .05). These findings were especially notable given the fact that the node-positive group had a higher percentage of T2 tumors and a higher percentage of patients in the young age group. These paradoxical findings, however, may be explained by the fact that 88% of the node-positive patients underwent adjuvant systemic therapy in the form of either systemic chemotherapy or hormonal therapy, while only 8% of node-negative patients underwent any adjuvant systemic therapy. When analyzed as a function of adjuvant therapy, those patients receiving adjuvant therapy had a lower local recurrence rate than those patients not receiving adjuvant therapy (P < .08). We conclude that adjuvant systemic therapy impacts on the ipsilateral breast recurrence rate in patients treated with CS + RT. The implications of this study in light of the widespread use of adjuvant systemic therapy are discussed.
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页码:997 / 1003
页数:7
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