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From the Departments of Surgical Oncology (NQM, GV, FM, NE, SES, HMK, LAN, FCA, MIR, BWF, REP, KKH) and Radiation Oncology (TAB, MM, ES), The University of Texas M. D. Anderson Cancer Center, Houston, Texas.
Correspondence: Address correspondence and reprint requests to: Kelly K. Hunt, MD, Department of Surgical Oncology, The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd., Box 444, Houston TX 77030; Fax: 713-792-4689; E-mail: khunt{at}manderson.org
Background: Our aim was to identify predictors of locoregional recurrence (LRR) in patients with early-stage breast cancer treated with breast-conserving therapy (BCT) and long-term follow-up.
Methods: From 1970 to 1994, 1153 patients with stage I to II breast cancer underwent BCT and radiotherapy at our institution. Patients with prior breast cancer or other primary malignancies were excluded. Clinical and pathologic characteristics evaluated were age, race, tumor size, stage, pathologic tumor margins, axillary nodal involvement, estrogen and progesterone receptor status, Black’s nuclear grade, type of surgery, and use of adjuvant therapy.
Results: Of 1083 patients, 54% presented with stage I disease and 46% with stage II disease. Median age was 50 years, and median follow-up was 9 years. Axillary nodes were positive in 31% of the patients who underwent axillary dissection. LRR developed in 6%, LRR followed by systemic recurrence in 5%, and systemic recurrence alone in 13%; 76% had no evidence of recurrence at last follow-up. Age, tumor size, positive lymph nodes, and not receiving chemotherapy or hormonal therapy were independent predictors of LRR. Disease-specific survival among patients with LRR was similar to that among patients with no recurrence.
Conclusions: Multidisciplinary treatment strategies should be used to accomplish durable locoregional control after BCT.
Key Words: Breast neoplasms • Local recurrence • Predictors • Breast-conserving therapy • Survival
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