The Patterns, the Survival, and the Change of Serologic Markers after Recurrence in Patients with Breast Cancer

ABSTRACT

It is difficult to predict the recurrence of or the prognosis for breast cancer because of its tortuous postoperative course. There are many clinical factors and serologic markers which might be associated with the recurrence of the breast cancer, their relationship to recurrence has not been settled. For this reason, carried out a clinical study to determine the risk of recurrence according to the clinical factors, to evaluate the survival rate after recurrence, and to determine the usefulness of several serologic markers which might be associated with recurrence. To that end, medical records of 365 out of 415 patients (except stage IV patient and patients of underknown whereabouts) with breast cancer who underwent surgical therapy between January 1986 and June 1996 at the Department of General Surgery, Hanyang University Hospital, were retrospectively reviewed. By the time of follow up, recurrence had occurred in 58 of those 365 patients. The DNA ploidy pattern, the primary tumor size, and primary lymph-node metastasis were associated with recurrence. The last two were high risk factors for recurrence of breast cancer. The most common site of recurrence was the locoregional area, followed by the visceral organs and bones. There was a significant differece in survival according to the location of recurrence. The poorest prognosis was obtained for patients with multiple metastases, followed by visceral and bone metastases. Patients with a locoregional metastasis has a better prognosis than others. The serologic markers that significantly increased at recurrence were CEA, ESR, alkaline phosphatase and r-glutamyl transferase. They should be useful serologic markers for diagnosing the recurrence of breast cancer. However, CA15-3 failed to show any statistical difference because of its low concentration. Therefore, better statistical data are required for CA15-3.