ABSTRACT
To explore prognostic factors for locoregional failures among women treated for invasive breast cancer by surgery and adjuvant therapies. Design: Descriptive study. Place and Duration: The study was conducted at the Surgical Department, Bahawal Victoria Hospital [BVH], Bahawalpur with mutual cooperation of Bahawalpur Institute of Nuclear Medicine and Oncology [BIND] over a period of five years. Patients And The study consisted of 120 women who were treated with a modified radical mastectomy [85 at BVH and 35 at various district and private hospitals] and enrolled for an adjuvant therapy. A total of 25 patients of breast cancer with node negative disease received either no adjuvant therapy or a single cycle of perioperative chemotherapy, and 95 women with node positive disease received adjuvant chemotherapy of at least 5 months duration and/or tamoxifen for at least one year. Mean follow up was 4.2 years. In women with node negative disease factors associated with increased risk of locoregional failure were vascular invasion [VI] and tumor size greater than 5 cm for premenopausal and VI for postmenopausal patients. Of the 25 patients, 6 [24%] met criteria for the high risk groups. For the node positive group of patients number of nodes and tumor grade were factors for both menopausal groups, with additional prediction provided by VI for premenopausal and tumor size for postmenopausal patients. Of the 95 patients, 34 [35.8%] met criteria for the high risk groups. Locoregional recurrence is a significant problem after mastectomy alone even for some patients with node negative breast cancer, as well as after mastectomy and adjuvant treatment for some subgroups of patients with node positive disease. In addition to number of positive lymph nodes, predictors of locoregional failures include tumor related factors, such as microscopic vascular invasion, higher grade and larger size