Department of Breast Surgery, Gachon University Gil Hospital, Incheon, Korea.
J Breast Cancer. 2012 Jun;15(2):218-23. doi: 10.4048/jbc.2012.15.2.218. Epub 2012 Jun 28.
Patients with recurrent breast cancer usually die of their disease, even after radical surgery and adjuvant therapies which could reduce the odds of dying. Many studies analyzed and compared patients who died of recurrent disease with those that died without recurrent disease. However, less attention has been paid to evaluating factors associated with the timing of recurrence. Thus, the objective of this study is to investigate the correlation between various factors and the timing of recurrence.
We retrospectively reviewed the data of 95 recurrent breast cancer patients who underwent curative surgery to determine the prognostic factors such as menopausal status, operation method, stage, nodal status, histologic grade, nuclear grade, extensive intraductal carcinoma component, hormone receptor, p53, c-erbB-2, Ki-67, and molecular subtype. We had attempted to compare the recurrent patients within 2 years after operation and adjuvant chemotherapies as the early recurrence with those over 2 years as the late recurrence.
Histologic grade (p=0.005), nuclear grade (p<0.001), p53 (p=0.022), and Ki-67 (p<0.001) were significant different factors that influenced the systemic recurrence between early recurrence and late recurrence. In stage I/II, histologic grade (p=0.001), nuclear grade (p<0.001), and Ki-67 (p=0.005) were significant factors that influenced the systemic early recurrence. In stage III, nuclear grade (p=0.024), and Ki-67 (p=0.001) were significant factors that influenced the systemic early recurrence. But subtypes (p=0.189, p=0.132, p=0.593, p=0.083) are not associated with the timing of recur rence.
In systemic recurrent breast cancer patients, the risk factors such as histologic grade, nuclear grade, p53 and Ki-67 are also associated with the timing of recurrence. We sug gest that these patients should be proper treated and be closely followed up.
复发性乳腺癌患者即使接受根治性手术和辅助治疗，降低了死亡风险，但仍通常死于疾病。许多研究分析并比较了死于复发性疾病的患者和未死于复发性疾病的患者。然而，对于与复发时间相关的因素评估较少。因此，本研究的目的是探讨各种因素与复发时间之间的相关性。
我们回顾性分析了 95 例接受根治性手术的复发性乳腺癌患者的数据，以确定与绝经状态、手术方法、分期、淋巴结状态、组织学分级、核分级、广泛导管内癌成分、激素受体、p53、c-erbB-2、Ki-67 和分子亚型等预后因素相关的因素。我们试图将术后 2 年内接受辅助化疗的患者作为早期复发患者，将术后 2 年以上的患者作为晚期复发患者进行比较。
组织学分级（p=0.005）、核分级（p<0.001）、p53（p=0.022）和 Ki-67（p<0.001）是影响早期复发和晚期复发的系统性复发的显著不同的因素。在 I/II 期，组织学分级（p=0.001）、核分级（p<0.001）和 Ki-67（p=0.005）是影响系统性早期复发的显著因素。在 III 期，核分级（p=0.024）和 Ki-67（p=0.001）是影响系统性早期复发的显著因素。但亚型（p=0.189、p=0.132、p=0.593、p=0.083）与复发时间无关。
在系统性复发性乳腺癌患者中，组织学分级、核分级、p53 和 Ki-67 等危险因素也与复发时间有关。我们建议对这些患者进行适当治疗并密切随访。
