Lokális recidíva fiatal (<or = 40 év) emlorákos betegeknél emlomegtartó mutét vagy mastectomia után: 15 éves eredmények.

Translated title of the contribution: Local relapse in young (<or = 40 years) women with breast cancer after mastectomy or breast conserving surgery: 15-year results

János Fodor, Emoke Mózsa, Zoltán Zaka, Csaba Polgár, Tibor Major

Research output: Contribution to journalArticle

Abstract

PURPOSE: Data from various sources indicate that after breast conserving surgery (BCS), younger patients have a high risk of local relapse, but there is insufficient evidence about the risk of post-mastectomy local recurrence. This study investigates the risk of local recurrence for young (<or = 40 years) patients treated with either conservative or radical surgery, with or without radiotherapy (RT). METHODS: 148 young (<or = 40 years) women with early invasive breast cancer underwent axillary dissection and mastectomy (n = 92) or BCS (n = 56) between January 1983 and December 1997. When adjuvant RT was given, the median dose was 50 Gy. The risk factors of local recurrence were estimated by uni- and multivariate analysis. RESULTS: At a median follow-up time of 199 months 60 (40.5%) women died of breast cancer. The type of surgery (mastectomy vs. wide tumour excision) had no significant impact on breast cancer-specific survival. The crude rate of local relapse for nonirradiated mastectomy and BCS patients was 24% and 75% (p = 0.0041), and for irradiated patients 4% and 23%, respectively (p = 0.0091). After mastectomy in univariate analysis nodal status (negative vs. positive) and RT (no vs. yes) were significant predictors of local control, but tumour size (T1 vs. T2) and histological grade (1-2 vs. 3) were not. In multivariate analysis both nodal involvement and omission of RT remained independent significant negative predictors of local control. After BCS in univariate analysis extensive intraductal component (EIC, negative vs. positive) and RT (no vs. yes) were significant predictors of local control, but tumour size (T1 vs. T2), nodal status (N0 vs. N1) and histological grade (1-2 vs. 3) were not. In multivariate analysis omission of RT and presence of EIC remained independent significant negative predictors of local control. The 15-year actuarial rate of local relapse was 29% for irradiated, and 75% for nonirradiated BCS patients (RR, 0.21; 95% CI, 0.07-0.55; p = 0.0052). The 15-year actuarial rate of local recurrence was 6% for irradiated, and 46% for nonirradiated node-positive mastectomy patients (RR, 0.12; 95% CI, 0.06-0.96; p = 0.0095). CONCLUSION: The incidence of local recurrence is high for young patients treated either with BCS or mastectomy, and RT significantly reduces the risk. The use of postmastectomy RT in node-positive patients gives a good local control. The efficacy of BCS and RT as a treatment modality for young patients needs further investigations.

Original languageHungarian
JournalMagyar Onkologia
Volume49
Issue number3
Publication statusPublished - 2005

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Segmental Mastectomy
Mastectomy
Radiotherapy
Breast Neoplasms
Recurrence
Multivariate Analysis
Neoplasms
Adjuvant Radiotherapy
Information Storage and Retrieval
Dissection
Survival
Incidence

ASJC Scopus subject areas

  • Cancer Research

Cite this

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title = "Lok{\'a}lis recid{\'i}va fiatal (<or = 40 {\'e}v) emlor{\'a}kos betegekn{\'e}l emlomegtart{\'o} mut{\'e}t vagy mastectomia ut{\'a}n: 15 {\'e}ves eredm{\'e}nyek.",
abstract = "PURPOSE: Data from various sources indicate that after breast conserving surgery (BCS), younger patients have a high risk of local relapse, but there is insufficient evidence about the risk of post-mastectomy local recurrence. This study investigates the risk of local recurrence for young (",
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