ABSTRACT
PURPOSE: Axillary lymph node metastasis is one of the most important prognostic factors in breast cancer. Previous reports show differences that clinicopathologic factors influence the systemic recurrence and survival in axillary lymph node negative breast cancer. Thus, we have attempted to determine the prognostic factors influence on the systemic recurrence and survival in axillary lymph node negative breast cancer. METHODS: We retrospectively reviewed the data of 1,351 node negative breast cancer patients who underwent curative surgery to determine the prognostic factors such as age, sex, body mass index (BMI), family history, bilateral breast cancer, operation method, tumor size, stage, histologic grade, number of resected lymph nodes, hormone receptor status, overexpression of p53 and c-erbB2, and adjuvant therapy that influence the systemic recurrence and 10-year-distant relapse-free survival. RESULTS: Systemic recurrence occurred in 58 patients (4.3%) during 53.3 months median follow up period. The tumor size (P=0.001), stage (P=0.005), histologic grade (P=0.049). ER (P=0.028), PR (P=0.002), overexpression of p53 (P=0.001) and bilateral breast cancer (P=0.043) were statistically significant factors that influenced the systemic recurrence. In multivariate analysis, only tumor size was associated with the systemic recurrence (P=0.003). Tumor size (P=0.004), histologic grade (P=0.035), ER (P=0.046), PR (P=0.001) and bilateral cancer (P=0.003) were statistically significant factors that influenced 10-year-distant relapse-free survival. CONCLUSION: The larger tumor size was determined to be an independent prognostic value in axillary lymph node negative breast cancer.
Subject(s)
Humans , Body Mass Index , Breast , Breast Neoplasms , Follow-Up Studies , Lymph Nodes , Multivariate Analysis , Neoplasm Metastasis , Recurrence , Retrospective StudiesABSTRACT
PURPOSE: To evaluate the independent prognostic value of Ki-67 in lymph node-negative breast cancer and the usefulness of Ki-67 when it combined with St. Gallen classification as a guidance of adjuvant chemotherapy for node-negative cancer. METHODS: We retrospectively reviewed the data of 534 patients with lymph node-negative breast cancer who underwent curative surgery between 1998 and 2001 at our institution. Patients were classified according to the guideline of risk groups of St. Gallen consensus and the level of Ki-67 expression. Distant metastasis-free survival (DFS) rates were compared between groups. RESULTS: With a median follow-up of 55 months, the overall 5-year DFS rate was 91.5%. The 5-year DFS rates for patients with high and low Ki-67 tumors (cut-off value: > or = 10%) were 84.6% and 93.7%, respectively (p < 0.001). In a Cox regression model involving potential prognostic factors, high Ki-67 expression could independently predict the risk of distant recurrence (odds ratio = 2.0 [95% confidence interval, 1.03-3.93]). The 5-year DFS rates for patients with average and minimal risk group of St. Gallen classification were 89.3% and 97.5%, respectively. The average risk group was further divided into two subgroups with significantly different prognosis according to the Ki-67 expression (DFS rate: 84.2% vs. 91.5%; p = 0.007). CONCLUSIONS: Ki-67 was an independent prognostic factor in lymph node-negative breast cancer and the combination of Ki-67 expression and the St. Gallen classification could provide a more useful therapeutic guideline for lymph node-negative breast cancer patients.
Subject(s)
Humans , Breast Neoplasms , Breast , Chemotherapy, Adjuvant , Classification , Consensus , Follow-Up Studies , Prognosis , Recurrence , Retrospective StudiesABSTRACT
PURPOSE: To evaluate the independent prognostic value of Ki-67 in lymph node-negative breast cancer and the usefulness of Ki-67 when it combined with St. Gallen classification as a guidance of adjuvant chemotherapy for node-negative cancer. METHODS: We retrospectively reviewed the data of 534 patients with lymph node-negative breast cancer who underwent curative surgery between 1998 and 2001 at our institution. Patients were classified according to the guideline of risk groups of St. Gallen consensus and the level of Ki-67 expression. Distant metastasis-free survival (DFS) rates were compared between groups. RESULTS: With a median follow-up of 55 months, the overall 5-year DFS rate was 91.5%. The 5-year DFS rates for patients with high and low Ki-67 tumors (cut-off value: > or = 10%) were 84.6% and 93.7%, respectively (p < 0.001). In a Cox regression model involving potential prognostic factors, high Ki-67 expression could independently predict the risk of distant recurrence (odds ratio = 2.0 [95% confidence interval, 1.03-3.93]). The 5-year DFS rates for patients with average and minimal risk group of St. Gallen classification were 89.3% and 97.5%, respectively. The average risk group was further divided into two subgroups with significantly different prognosis according to the Ki-67 expression (DFS rate: 84.2% vs. 91.5%; p = 0.007). CONCLUSIONS: Ki-67 was an independent prognostic factor in lymph node-negative breast cancer and the combination of Ki-67 expression and the St. Gallen classification could provide a more useful therapeutic guideline for lymph node-negative breast cancer patients.