Impact of primary local treatment on the development of distant metastases or death through locoregional recurrence in young breast cancer patients
| Autor: | Johannes A. Langendijk, de Gh Bock, Carolien P. Schröder, Wgjm Smit, E.J. Bantema-Joppe, de Linda Munck, W. V. Dolsma, John H. Maduro, Liesbeth Jansen, Paul R. Timmer, van den Er Edwin Heuvel, Sabine Siesling |
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| Přispěvatelé: | Faculty of Behavioural, Management and Social Sciences, Damage and Repair in Cancer Development and Cancer Treatment (DARE), Life Course Epidemiology (LCE), Guided Treatment in Optimal Selected Cancer Patients (GUTS) |
| Rok vydání: | 2013 |
| Předmět: |
Oncology
Adult Cancer Research medicine.medical_specialty PROGNOSIS CARCINOMA medicine.medical_treatment Young Breast Neoplasms Mastectomy Segmental Breast cancer CONSERVING THERAPY RADIATION-THERAPY Internal medicine medicine Carcinoma Humans Cumulative incidence Locoregional recurrence Breast conserving therapy Pathological Survival analysis Mastectomy CONSERVATIVE SURGERY Radiotherapy business.industry fungi WOMEN medicine.disease REGIONAL RECURRENCE Radiation therapy STAGE-I Increased risk Multivariate Analysis Female Therapy POOR SURVIVAL Neoplasm Recurrence Local business Follow-Up Studies |
| Zdroj: | Breast cancer research and treatment, 140(3), 577-585. Springer Breast Cancer Research and Treatment, 140(3), 577-585. SPRINGER |
| ISSN: | 1573-7217 0167-6806 |
| Popis: | In this study, we tested the hypothesis whether breast conserving therapy (BCT) compared with mastectomy is associated with a negative outcome in terms of distant metastases or death (DMD) and investigated the relation between locoregional recurrence (LRR) and DMD in young breast cancer (BC) patients. This study included a consecutive series of 536 patients a parts per thousand currency sign40 years of age at diagnosis with pathological T1N0-3M0 BC, treated between 1989 and 2005. A multistate survival model was used to evaluate the influences of local treatment and LRR on DMD, adjusted for potential prognostic factors. Patients were treated with mastectomy (N = 213) or BCT (N = 323). Median age at diagnosis was 36.3 years, with a median follow-up of 9.0 years. The 10-year actuarial cumulative incidence of DMD was 30.6 % after mastectomy and 26.3 % after BCT (P = 0.04). In total, 81 (15 %) LRRs were observed. After BCT, patients had a threefold higher risk of LRR than after mastectomy (HR 2.9; 95 % CI 1.6-5.3). Patients with LRR had a higher risk of DMD compared with patients without LRR (HR 5.5; 95 % CI 2.1-14.5). However, BCT was not negatively associated with DMD-after-LRR (HR 0.47; 95 % CI 0.2-1.1, BCT vs mastectomy). In conclusion, although LRR significantly affected DMD, the increased risk of LRR after BCT compared with mastectomy did not lead to a worse DMD outcome in BC patients a parts per thousand currency sign40 years of age. |
| Databáze: | OpenAIRE |
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