Risk Factors of Local Recurrence after Breast Conserving Therapy in Invasive Breast Cancer

On Vox Yi; Jong Won Lee; Hee Jung Kim; Woo Sung Lim; Eun Hwa Park; Jung Sun Lee; Byung Ho Son; Gyungyub Gong; Seung Do Ahn; Sei-Hyun Ahn

doi:10.4048/jbc.2009.12.4.302

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Yi, Lee, Kim, Lim, Park, Lee, Son, Gong, Ahn, and Ahn: Risk Factors of Local Recurrence after Breast Conserving Therapy in Invasive Breast Cancer

Original Article

Journal of Breast Cancer

Journal of Breast Cancer 2009; 12(4): 302-308.

Published online: 31 December 2009

DOI: https://doi.org/10.4048/jbc.2009.12.4.302

Risk Factors of Local Recurrence after Breast Conserving Therapy in Invasive Breast Cancer

On Vox Yi, Jong Won Lee, Hee Jung Kim, Woo Sung Lim, Eun Hwa Park, Jung Sun Lee, Byung Ho Son, Gyungyub Gong¹, Seung Do Ahn², Sei-Hyun Ahn

Depatment of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.

¹Depatment of Pathology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.

²Depatment of Radiation Oncology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.

Corresponding author (ahnsh@amc.seoul.kr)

Received 13 January 2009 Accepted 30 October 2009

Abstract

Purpose

Twenty-year follow-up results of two pioneering randomized controlled trials have demonstrated equal patient survival after mastectomy and breast conservation therapy. The use of breast conservation therapy has undoubtedly provided substantial progress towards a better quality of life for women with breast cancer. Outcomes of breast conservation therapy performed at Asan medical center were retrospectively reviewed and analyses were performed to determine significant risk factors of local recurrence.

Methods

A total of 578 women with stage I, stage II or stage III breast cancer were treated with conservative surgery and radiation therapy between January 1997 and December 2002. Outcomes of local recurrence and survival were recorded.

Results

During a median follow-up of 54.1 months, 21 patients (3.6%) developed local recurrence as first event and 10 patients (1.7%) developed regional recurrence and 19 patients (3.3%) developed systemic recurrence. Univariate analysis of the prognostic factors determined that age (p=0.005), nuclear grade (p=0.013), estrogen receptor negativity (p=0.008), lymphovascular invasion (p=0.009), progesterone receptor negativity (p=0.016) and lack of hormone therapy (p=0.005) were statistically significant factors associated only with locoregional recurrence. Results of multivariate analysis determined that lymphovascular invasion (p=0.045) strongly independent predictors for local recurrence.

Conclusion

Age, nuclear grade, estrogen receptor negativity, lymphovascular invasion, progesterone receptor negativity and lack of hormone therapy were associated with local recurrence after Breast conserving surgery. The lymphovascular invasion was the strongest independent risk factors for local recurrence.

Keywords: Breast conserving surgery, Breast neoplasms, Local recurrence, Risk factor

Figures and Tables

Figure 1

Disease free survival curve according to risk factor.

Table 1

Clinicopathologic characteristics (Total No.=578)

ER=estrogen receptor; PR=progesterone receptor; ALN=axillary lymph node; RM=resection margin; LVI=lymphovascular invasion; EIC=extensive intraductal component.

Table 2

Univariate analysis of Risk factor for Local recurrence

χ=chi-square test; LR=local recurrence; ER=estrogen receptor; PR=progesterone receptor; ALN=axillary node; RM=resection margin; LVI=lympho vascular invasion; EIC=extensive intraductal component.

Table 3

Multivariate analysis of Risk factor for Local recurrence

ER=estrogen receptor; PR=progesterone receptor; LVI=lympho vascular invasion.

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