Prognostic Factors Influence on the Systemic Recurrence in Axillary Lymph Node Negative Breast Cancer

Analysis of factors related systemic recurrence after breast conserving surgery in stage I breast cancer

Objectives In these days, patients with stage I breast cancer have increased by regular health examination and diagnostic tool development. The aim of this retrospective study is to identify systemic recurrence related factors after breast conserving surgery (BCS) for stage I breast cancer. Methods In this study, we analyzed the correlation between systemic recurrence and pathologic factors. We reviewed 223 patients who underwent BCS for stage I breast cancer. Postoperative pathologic factors, recurrent rates and sites were studied. In addition, preoperative patients'data were also collected. Statistical analysis was done by using PASW 16.0 (SPSS Inc., Chicago, IL, USA). Results Systemic recurrence was found in 16 patients (7.17%) within 5 years after primary surgery. 5 patients had lymphatic invasion and 6 patients had vascular invasion. Lymphatic and vascular invasion had statistical correlation with systemic recurrence ( P = 0.004, P = 0.001). Conclusions In this retrospective study, we can conclude that vascular invasion and lymphatic invasion are related systemic recurrence after BCS for stage I patients. Further studies with large cohort will be required to fully understand the risk factors of systemic recurrence for stage I breast cancer patients.

Vascular invasion as an independent prognostic factor in lymph node negative invasive breast cancer

INTRODUCTION

Identification of simple and measurable prognostic factors is an important issue in treatment evaluation of breast cancer. The present study was conducted to evaluate the prognostic role of vascular invasion in lymph node negative breast cancer patients.

METHODS

in a retrospective design, we analyzed the recorded profiles of the 1,640 patients treated in the breast cancer department of Motahari clinic affiliated to Shiraz University of Medical Sciences, Shiraz, Iran, from January 1999 to December 2012. Overall and adjusted survivals were evaluated by the Cox proportional hazard model. All the hypotheses were considered two-sided and a p-value of 0.05 or less was considered as statistically significant.

RESULTS

Mean age in lymph node negative and positive patients was 50.0 and 49.8 respectively. In lymph node negative patients, the number of nodes, tumor size, lymphatic invasion, vascular invasion, progesterone receptor, and nuclear grade were significant predictors. In lymph node and lymphatic negative patients, vascular invasion also played a significant prognostic role in the survival which was not evident in lymph node negative patients with lymphatic invasion.

DISCUSSION

The results of our large cohort study, with long term follow up and using multivariate Cox proportional model and comparative design showed a significant prognostic role of vascular invasion in early breast cancer patients. Vascular invasion as an independent prognostic factor in lymph node negative invasive breast cancer.