The recurrence rate, risk factors and recurrence patterns after surgery in 3700 patients with operable breast cancer / 한국유방암학회지

ABSTRACT

PURPOSE: This study was aimed at evaluating the recurrence rate and recurrence patterns after surgically treating for patients with operable breast cancer. METHODS: From 1992 to 2002, 3700 patients with breast cancer (stages 0-3) who underwent mastectomy or breast conservation surgery at Asan Medical Center, Seoul, were selected for this retrospective study. We analyzed the recurrence rate, the annual hazard rate, the risk factors, the time to recurrence and the recurrence patterns according to the clinicopathologic factors. RESULTS: During the median follow-up period of 45 months, 523 patients (14.1%) of the total 3700 patients developed recurrences locoregional recurrences occurred in 148 patients (4.0%), distant recurrences occurred in 319 patients (8.6%), and both types occurred in 56 patients (1.5%). The 5-year and 10-year recurrence rates were 17.7% and 23.4%, respectively. The recurrence rate increased in proportion to the cancer stage. The annual hazard rate for recurrence had a peak at 2-years of follow-up. On multivariate analysis, the stage, progesterone receptor status, and c-erbB2 expression were the independent risk factors for recurrence. The median time to recurrence among the patients with recurrence was 24.0 months. 50.5% of recurrences were found within 2 years and 92.0% of recurrences were found within 5 years after surgery. A short time to recurrence was significantly associated with an increased stage, a negative progesterone receptor status, and locoregional recurrences. The common recurrence sites included the chest wall, SCLN and the axillary lymph nodes in a locoregional order, and the bone, lung and liver in a systemic order. Of note is that distant recurrences commonly occurred at multiple sites in a simultaneous manner. CONCLUSION: Our findings revealed that the 5 year-recurrence rate was 17.7% and the risk of recurrence was maintained 5 years later after surgery, although the annual hazard rate had the highest peak at 2 years after breast cancer surgery. Because the stage, progesterone receptor status, and c-erbB2 expression are independent risk factors, early detection of breast cancer is required for reducing recurrence.