早期乳腺癌保乳治疗后局部复发患者的预后。

Prognosis following local recurrence after breast conserving treatment in young women with early breast cancer.

机构信息

Department of Radiation Oncology, Catharina Hospital, P.O. Box 1350, 5602 ZA Eindhoven, The Netherlands.

出版信息

Eur J Surg Oncol. 2013 Aug;39(8):892-8. doi: 10.1016/j.ejso.2013.05.004. Epub 2013 May 30.

DOI:10.1016/j.ejso.2013.05.004

PMID:23726902

Abstract

BACKGROUND

Few studies have focussed on the prognosis of young women with local recurrence (LR) after breast-conserving therapy and the factors that can be used to predict their prognosis.

METHODS

We studied the outcome and related prognostic factors in 124 patients with an isolated local recurrence in the breast following breast-conserving surgery and radiotherapy for early stage breast cancer diagnosed at the age of 40 years or younger.

RESULTS

The median follow-up of the patients after diagnosis of LR was 7.0 years. At 10 years from the date of salvage treatment, the overall survival rate was 73% (95% CI, 63-83), the distant recurrence-free survival rate was 61% (95% CI, 53-73), and the local control rate (i.e. survival without subsequent LR or local progression) was 95% (95% CI, 91-99). In the multivariate analysis, the risk of distant metastases also tended to be higher for patients with LR occurring within 5 years after BCT, as compared to patients with LR more than 5 years after BCT (Hazard ratio [HR], 1.89; p = 0.09). A worse distant recurrence-free survival was also observed for patients with a LR measuring more than 2 cm in diameter, compared to those with a LR of 2 cm or smaller (HR, 2.88; p = 0.007), and for patients with a LR causing symptoms or suspicious findings at clinical breast examination, compared to those with a LR detected by breast imaging only (HR 3.70; p = 0.03).

CONCLUSIONS

These results suggest that early detection of LR after BCT in young women can improve treatment outcome.

摘要

背景

很少有研究关注保乳治疗后局部复发（LR）的年轻女性的预后以及可用于预测其预后的因素。

方法

我们研究了 124 例年龄在 40 岁或以下的早期乳腺癌患者接受保乳手术和放疗后发生孤立性乳腺局部复发（LR）后的结局和相关预后因素。

结果

LR 诊断后患者的中位随访时间为 7.0 年。在挽救治疗后 10 年，总生存率为 73%（95%CI，63-83），远处无复发生存率为 61%（95%CI，53-73），局部控制率（即无后续 LR 或局部进展的生存）为 95%（95%CI，91-99）。多因素分析显示，与 BCT 后 5 年以上发生 LR 的患者相比，BCT 后 5 年内发生 LR 的患者发生远处转移的风险也更高（风险比 [HR]，1.89；p=0.09）。LR 直径大于 2cm 的患者远处无复发生存率较差，与 LR 直径为 2cm 或更小的患者相比（HR，2.88；p=0.007），以及在临床乳房检查中出现症状或可疑发现的 LR 患者与仅通过乳房成像检测到的 LR 患者相比（HR 3.70；p=0.03）。