PURPOSE: The prognostic role of the site of the primary breast cancer has not been clarified. This study aimed to gather more information about this issue from a large series of patients with long-term follow-up data. PATIENTS AND METHODS: Data from 2,396 patients treated for early breast cancer with a conservative approach were reviewed (1973 to 1989). In 1,619 patients, the tumor had a lateral site, while in 777 cases, it was situated in the internal/central quadrants. The characteristics of the two groups were well balanced, apart from axillary nodal metastases, which were more frequent for lateral tumors (38.1% v 26.3%). RESULTS: Analysis of distant metastases indicated that the regression coefficient associated with tumor site was significant and the hazards ratio estimate was 1.291, which indicates the risk of distant metastases was increased by approximately 30% for internal/central tumors. The analysis of overall survival yielded a significant coefficient and a hazards ratio of 1.192, which indicates an approximately 20% increase of mortality for internal/central tumors. CONCLUSION: Early breast cancers situated in central/ internal quadrants have a worse prognosis compared with those in lateral quadrants, in terms of distant metastases and survival. Irradiation of the internal mammary chain for internal/medial tumors could be suggested, but, to date, the therapeutic strategy is still controversial.
PURPOSE: The prognostic role of the site of the primary breast cancer has not been clarified. This study aimed to gather more information about this issue from a large series of patients with long-term follow-up data. PATIENTS AND METHODS: Data from 2,396 patients treated for early breast cancer with a conservative approach were reviewed (1973 to 1989). In 1,619 patients, the tumor had a lateral site, while in 777 cases, it was situated in the internal/central quadrants. The characteristics of the two groups were well balanced, apart from axillary nodal metastases, which were more frequent for lateral tumors (38.1% v 26.3%). RESULTS: Analysis of distant metastases indicated that the regression coefficient associated with tumor site was significant and the hazards ratio estimate was 1.291, which indicates the risk of distant metastases was increased by approximately 30% for internal/central tumors. The analysis of overall survival yielded a significant coefficient and a hazards ratio of 1.192, which indicates an approximately 20% increase of mortality for internal/central tumors. CONCLUSION: Early breast cancers situated in central/ internal quadrants have a worse prognosis compared with those in lateral quadrants, in terms of distant metastases and survival. Irradiation of the internal mammary chain for internal/medial tumors could be suggested, but, to date, the therapeutic strategy is still controversial.
Authors: Wolfgang Janni; Brigitte Rack; Harald Sommer; Maren Schmidt; Barbara Strobl; Dorothea Rjosk; Elisabeth Klanner; Wiebke Thieleke; Bernd Gerber; Klaus Friese; Thomas Dimpfl Journal: J Cancer Res Clin Oncol Date: 2003-07-18 Impact factor: 4.553
Authors: Elisabeth Bräutigam; Christine Track; Dietmar H Seewald; Johann Feichtinger; Kurt Spiegl; Josef Hammer Journal: Strahlenther Onkol Date: 2009-10-06 Impact factor: 3.621
Authors: Mohamed A Alm El-Din; Kevin S Hughes; Rita A Raad; Saveli I Goldberg; Alan C Aisenberg; Andrzej Niemierko; Alphonse G Taghian Journal: Radiat Oncol Date: 2009-06-30 Impact factor: 3.481
Authors: Cong Xue; Rou Jun Peng; Shu Sen Wang; Yan Xia Shi; Xin An; Fei Xu; Zhong Yu Yuan Journal: J Breast Cancer Date: 2015-03-27 Impact factor: 3.588
Authors: Yunan Han; Justin Xavier Moore; Marvin Langston; Lindsay Fuzzell; Saira Khan; Marquita W Lewis; Graham A Colditz; Ying Liu Journal: Cancer Causes Control Date: 2019-08-27 Impact factor: 2.506