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J Korean Soc Ther Radiol > Volume 15(4); 1997 > Article
Journal of the Korean Society for Therapeutic Radiology 1997;15(4): 331-338.
Risk Factors for Recurrence after Conservative Treatment in Early Breast Cancer: Preliminary Report
Chang Ok Suh, Eun Ji Chung, Hy De Lee, Kyong Sik Lee, Ki Keun Oh, Gwi Eon Kim
1Department of Radiation Oncology, Yonsei University College of Medicine, Yonsei Cancer Center, Seoul, Korea.
2Department of Surgery, Yonsei University College of Medicine, Yonsei Cancer Center, Seoul, Korea.
3Department of Diagnostic Radiology, Yonsei University College of Medicine, Yonsei Cancer Center, Seoul, Korea.
To evaluate our experience in the breast-conserving treatment for early breast cancer with special regard to recurrence pattern and related risk factors. MATERIALS AND METHOD: Two hundred and sixteen patients with AJC stagei and ii breast cancer who received breast conserving treatment between January 1991 and December 1994 were evaluated. Age distribution ranged from 23-80 year old with a median age of 44. One hundred and seventeen patients had T1 lesions and 99 patients had T2 lesions. Axillary lymph nodes were involved in 73 patients. All patients received a breast conserving surgery (wide excision to quadrantectomy) and axillary node dissection followed by radiotherapy. Ninety six patients received chemotherapy before or after radiotherapy.
During the follow-up period (3-60 months, median 30 months), local recurrences were noted in six patients (true; 3, elsewhere; 1, skin; 2). Sixteen patients developed distant metastases as the first sign of recurrence at 8-38 months (median 20 months) after surgery. Among them, three patients simultaneously developed local recurrence with distant metastases. Contralateral breast cancer developed in one patient and non-mammary cancers developed in three patients. The actuarial 5 year survival rate was 88.4% (stage i 96.7%, stage iia 95.2%, stage iib 69.9%). Age, T stage, number of involved axillary lymph nodes, and AJC stage were risk factors for distant metastases in univariate analysis. In the multivariate analysis, the number of involved axillary lymph nodes was the most significant risk factor for metastases.
Local recurrence was not common in the early years after radiotherapy. Distant metastases occurred at a steady rate during the first three years and was more common in the patients with larger tumors, highernumber of involved axillary nodes, and younger age.
Key Words: Breast cancer, Breast conservation treatment
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