+ Site Statistics
+ Search Articles
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ PDF Full Text
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Translate
+ Recently Requested

Loco-regional recurrences after mastectomy in breast cancer: Prognostic factors and implications for postoperative irradiation

Loco-regional recurrences after mastectomy in breast cancer: Prognostic factors and implications for postoperative irradiation

Radiotherapy & Oncology 50(3): 267-275

Purpose: Potential risk factors including DNA flow cytometric-derived parameters predicting loco-regional recurrence (LRR) in early breast cancer were investigated. Materials and methods: This study included 608 patients treated by modified radical mastectomy between 1982 and 1987. Recommendations regarding local treatment as well as adjuvant systemic therapy did not change during this period. Patients treated by adjuvant chemotherapy were randomized to receive additional medroxyprogesterone acetate (MPA) treatment. Only 59 (10%) patients received postoperative irradiation (XRT) to the chest wall and/or axillary lymph nodes; another 121 (20%) patients received XRT to the internal mammary nodes because of centromedially located tumours. Results: Patients were followed for a median period of 7.5 years. The event-free survival at 10 years was 50%. The cumulative incidence rate of LRR at 10 years was 18% (n = 93), either with (n = 30) or without (n = 63) concurrent distant metastases. The chest wall, regional lymph nodes or both were involved in 41 (44%), 38 (41%) and 12 (13%) patients, respectively. Multivariate analysis according to the Cox model revealed two factors associated with LRR, i.e. pT (P < 0.05) and nodal status (P < 0.05). In node-positive patients extracapsular tumour extension (ECE) and pT were independent risk factors. DNA ploidy and S-phase fraction did not yield additional information. Based on pT, nodal status and extracapsular extension of tumour growth a high risk ( > 10%) and low risk ( < 10%) group for LRR could be identified. Conclusions: Results indicate that T-stage and nodal status, combined with ECE, may help to identify patients at risk for loco-regional recurrence, whereas DNA flow cytometry does not.

(PDF emailed within 0-6 h: $19.90)

Accession: 010932806

Download citation: RISBibTeXText

PMID: 10392812

DOI: 10.1016/s0167-8140(98)00118-2

Related references

Classical prognostic factors for survival and loco-regional control in breast cancer patients treated with radical mastectomy alone. Acta Oncologica (stockholm). 33(7): 759-765, 1994

Flow cytometry DNA analysis and prediction of loco-regional recurrences after mastectomy in breast cancer. Acta Oncologica 31(7): 733-740, 1992

Loco-regional recurrence patterns following mastectomy and doxorubicin-based chemotherapy Implications for postoperative irradiation. Cancer Journal 6(2): 107, March-April, 2000

Value of radiotherapy in preventing loco-regional recurrences after radical mastectomy for carcinoma of the breast. Boletin de la Asociacion Medica de Puerto Rico 74(10): 289-294, 1982

Loco regional failure pattern after lumpectomy and breast irradiation in 4,185 patients with T1 and T2 breast cancer. Implications for nodal irradiation. Acta Oncologica 45(5): 564-570, 2006

Loco-regional recurrence rates and prognostic factors for failure in node-negative patients treated with mastectomy alone Implications for postmastectomy radiation. International Journal of Radiation Oncology Biology Physics 57(2 Supplement): S128-S129, 2003

The impact of isolated tumor cells on loco-regional recurrence in breast cancer patients treated with breast-conserving treatment or mastectomy without post-mastectomy radiation therapy. Breast Cancer Research and Treatment 146(2): 365-370, 2015

Analysis of loco-regional control rate, metastatic remission and survival in 178 breast cancer patients treated by radical modified mastectomy and post-operative irradiation. La Semaine des Hopitaux 56(29-32): 1245-1248, 1980

Prognostic significance of isolated local recurrences in breast cancer following mastectomy and axillary node excision. Apropos of 77 recurrences in 2362 patients. Bulletin du Cancer 73(5): 497-503, 1986

Efficacy of loco-regional lymphnodes irradiation after mastectomy for breast cancer with biopsy proven parasternal lymphnodes metastases A randomized study. International Journal of Radiation Oncology Biology Physics 36(1 SUPPL ): 277, 1996

Prognostic implications of age in breast cancer patients treated with tumorectomy and irradiation or with mastectomy. International Journal of Radiation Oncology, Biology, Physics 14(4): 659-664, 1988

Prognostic factors associated with the survival of patients developing loco-regional recurrences of differentiated thyroid carcinomas. Journal of Clinical Endocrinology and Metabolism 89(11): 5362-5368, 2004

Prognostic Factors for Local, Loco-regional and Systemic Recurrence in Early-stage Breast Cancer. Geburtshilfe und Frauenheilkunde 75(7): 710-718, 2015

Relationship between the prognostic and predictive value of the intrinsic subtypes and a validated gene profile predictive of loco-regional control and benefit from post-mastectomy radiotherapy in patients with high-risk breast cancer. Acta Oncologica 53(10): 1337-1346, 2015

18F-FDG PET-CT imaging in the neoadjuvant setting for stages II-III breast cancer: association of loco‑regional SUVmax with classical prognostic factors. Quarterly Journal of Nuclear Medicine and Molecular Imaging 58(1): 66-73, 2014