Tinne Laurberg1, Christina Daugaard Lyngholm2, Peer Christiansen3, Jan Alsner2, Jens Overgaard2. 1. Department of Experimental Clinical Oncology, Aarhus University Hospital, Denmark. Electronic address: laurberg@oncology.au.dk. 2. Department of Experimental Clinical Oncology, Aarhus University Hospital, Denmark. 3. Breast Surgery Unit, Aarhus University Hospital/Randers Regional Hospital, Denmark.
Abstract
PURPOSE: To describe long-term failure pattern after early-stage breast cancer in relation to local treatment (breast-conserving therapy (BCT) or mastectomy) and age. MATERIALS AND METHODS: Cohort study with balanced 5-year age groups and prospectively collected data; 813 Danish lymph-node-negative breast cancer patients diagnosed in 1989-98 and treated with mastectomy (N=515) or BCT (N=298) and no adjuvant systemic treatment. RESULTS: The 20-year local recurrence (LR) risk was 20% after BCT; 8.7% after mastectomy. LR developed in mastectomy patients within the first 10years; in BCT patients throughout the entire 20-year period. Younger patients' (⩽45years) 20-year LR risk was generally higher than older patients' (>45years) (19% vs. 5%, p<0.001). In younger patients, LR was significantly associated with distant metastasis (DM) (hazard ratio (HR)=2.7(1.8-4.2)) and 20-year breast-cancer mortality (HR=2.7(1.7-4.4)). BCT was associated with higher 20-year breast-cancer mortality (HR=1.5(1.0-2.4)) and higher 20-year all-cause mortality (HR=1.7(1.2-2.5)) than mastectomy. In older patients, LR was not associated with DM, and breast-cancer mortality was similar for BCT and mastectomy. CONCLUSION: BCT patients with no adjuvant systemic treatment developed LR throughout 20-year period and faced higher LR risk than mastectomy patients. LR was associated with DM among younger patients, and younger BCT patients had higher mortality than younger mastectomy patients.
PURPOSE: To describe long-term failure pattern after early-stage breast cancer in relation to local treatment (breast-conserving therapy (BCT) or mastectomy) and age. MATERIALS AND METHODS: Cohort study with balanced 5-year age groups and prospectively collected data; 813 Danish lymph-node-negative breast cancerpatients diagnosed in 1989-98 and treated with mastectomy (N=515) or BCT (N=298) and no adjuvant systemic treatment. RESULTS: The 20-year local recurrence (LR) risk was 20% after BCT; 8.7% after mastectomy. LR developed in mastectomy patients within the first 10years; in BCT patients throughout the entire 20-year period. Younger patients' (⩽45years) 20-year LR risk was generally higher than older patients' (>45years) (19% vs. 5%, p<0.001). In younger patients, LR was significantly associated with distant metastasis (DM) (hazard ratio (HR)=2.7(1.8-4.2)) and 20-year breast-cancer mortality (HR=2.7(1.7-4.4)). BCT was associated with higher 20-year breast-cancer mortality (HR=1.5(1.0-2.4)) and higher 20-year all-cause mortality (HR=1.7(1.2-2.5)) than mastectomy. In older patients, LR was not associated with DM, and breast-cancer mortality was similar for BCT and mastectomy. CONCLUSION: BCT patients with no adjuvant systemic treatment developed LR throughout 20-year period and faced higher LR risk than mastectomy patients. LR was associated with DM among younger patients, and younger BCT patients had higher mortality than younger mastectomy patients.
Authors: S Sinnadurai; A Kwong; M Hartman; E Y Tan; N T Bhoo-Pathy; M Dahlui; M H See; C H Yip; N A Taib; N Bhoo-Pathy Journal: BJS Open Date: 2018-10-18