Positive surgical margins and ipsilateral breast tumor recurrence predict disease-specific survival after breast-conserving therapy.

摘要: BACKGROUND The current study identified determinants of systemic recurrence and disease-specific survival (DSS) in patients with early-stage breast carcinoma treated breast-conserving surgery radiation therapy (breast-conserving therapy, or BCT). METHODS The population consisted 1,043 consecutive women Stages I II who underwent BCT between 1970 1994. Clinical pathologic characteristics evaluated included age, tumor size, grade, estrogen progesterone receptor status, surgical margins, axillary lymph node involvement, use adjuvant therapy. RESULTS At a median follow-up time 8.4 years, 127 (12%) had developed an ipsilateral (IBTR), 184 (18%) recurrence. On multivariate logistic regression analysis, size greater than 2 cm, positive nodes, lack tamoxifen margins (odds ratio [OR], 3.7; 95% confidence interval [CI], 1.1-12.3; P = 0.034) were predictors When IBTR was added into the model, not independent predictors; however, predictor (IBTR vs. no IBTR; OR, 6.2; CI, 3.1-12.3; < 0.001). The 10 year DSS rate after 87%. Cox proportional hazards model following factors poor DSS: cm (vs. ≤ cm; relative risk [RR], 2.3; 1.2-4.3; 0.010), negative status positive; RR, 2.7; 1.4-5.1; 0.003), negative; 3.9; 1.4-11.5; 0.011), 5.5; 2.8-11.0; 0.001). CONCLUSIONS Positive are BCT. Aggressive local is necessary to ensure adequate minimize IBTR. Cancer 2003;97:926–33. © 2003 American Society. DOI 10.1002/cncr.11222