Risk factors for local recurrence after breast-conserving therapy

Abstract

a significant independent risk factor for local recurrence, while radiation therapy (P ϭ 0.0457) significantly decreased recurrence. In patients with a negative surgical margin, radiation therapy (P ϭ 0.0158) and adjuvant endocrine therapy (P ϭ 0.0421) significantly reduced the relative risk of local recurrence, to 0.160 and 0.366, respectively. In patients with a positive surgical margin, radiation therapy marginally significantly (P ϭ 0.0756) reduced the relative risk of local recurrence, to 0.181, and adjuvant endocrine therapy significantly (P ϭ 0.0119) reduced the risk, to 0.076. Conclusions. Young age and lack of radiation therapy or adjuvant endocrine therapy were risk factors for local recurrence in breast cancer patients treated with breastconserving therapy, with surgical margin status also being a possible risk factor. AbstractBackground. Breast-conserving therapy has been widely accepted as a standard treatment for early breast cancer both in Western countries and in Japan. In Western countries, many studies have investigated the risk factors for local recurrence after breast-conserving therapy (BCT), but few such studies have been done in Japan. Methods.To determine the risk factors for local recurrence in 399 breast cancer patients (stage I and II, n ϭ 396; stage III, n ϭ 3) who had undergone BCT with or without postoperative radiation therapy, we evaluated their clinicopathological features by univariate and multivariate analyses. The patients were treated at Osaka National Hospital between February 1988 and December 1997. Results. Univariate analysis showed that a young age (Յ45 years; P ϭ 0.0005) was a significant risk factor for local recurrence, while radiation therapy (P ϭ 0.0058) and adjuvant endocrine therapy (P ϭ 0.0041) significantly reduced the risk of local recurrence. In patients with BCT, without radiation therapy a positive surgical margin significantly increased the risk of local recurrence (P ϭ 0.0470). Multivariate analysis showed that a young age (P ϭ 0.0285) was

Correlation between clinical features and prognosis of local recurrence after breast-conserving therapy

“…Our previous study 10 showed that radiotherapy reduced the local recurrence rate after breast-conserving surgery (BCS), but did not improve the prognosis when compared with BCS alone. A randomized clinical trial, 12 the National Surgical Adjuvant Breast and Bowel Project B-06, comparing lumpectomy alone with lumpectomy followed by radiotherapy showed that the local recurrence rate was significantly higher in patients treated with lumpectomy alone than in those having lumpectomy followed by radiotherapy to the whole conserved breast, while the distant metastasis rate was equivalent in the two groups.…”

“…The selection criteria and the BCT method have been reported previously. 9,10 One hundred and twenty-seven patients underwent quadrantectomy, including 17 patients who had quadrantectomy followed by radiotherapy (RT; Table 1). Two hundred and seventy-two patients underwent lumpectomy, including 250 patients who had lumpectomy followed by radiotherapy (Table 1).…”