Rigon A, Friso L, Lora O, Pignataro M, Berti F, Mazzarotto R, Simonato F, Calzavara F
Divisione di Radioterapia e Medicina Nucleare, Azienda Ospedaliera, Padova.
Radiol Med. 1995 Dec;90(6):794-6.
In the conservative treatment of early breast cancer, great attention must be paid to define the prognostic factors correlated with the local recurrence rate. The goal is to customize surgery, radiotherapy and chemotherapy to the risk predicted in every single patient. To investigate the impact of some prognostic factors in a group of patients treated with homogeneous treatment schedules, 251 women with UICC stage I or II breast cancer were examined in the Padua Radiotherapy Department from 1988 to 1990. All patients underwent conservative surgery consisting in quadrantectomy, axillary node dissection and radiotherapy. During a median follow-up period of 49.2 months, 12 patients presented a breast relapse (4.8%). In 4 patients the relapse occurred in the same quandrant as the primary lesion, whereas a different quadrant was involved in the other 8 patients. The relapse rate in women under 60 was 5% and 4.7% in older patients, with p = 0.73. In pT1 patients, the relapse rate was 4.5% and in pT2 patients it was 7.9% (p = 0.37). No significant difference was observed between pN- and pN+ patients (4.5% vs. 6.25%, p = 0.37). In our series, none of the studied factors significantly influenced breast relapse rates. The number of patients may be too little relative to the low rate of relapses. However, an unfavorable trend was observed in the patients under 60, in pT2 or pN+ patients, or in the patients with positive or unknown surgical margins.
在早期乳腺癌的保守治疗中，必须高度重视确定与局部复发率相关的预后因素。目标是根据每个患者预测的风险来定制手术、放疗和化疗方案。为了研究在一组接受同质化治疗方案的患者中某些预后因素的影响，1988年至1990年期间在帕多瓦放射治疗科对251例UICC I期或II期乳腺癌女性患者进行了检查。所有患者均接受了包括象限切除术、腋窝淋巴结清扫术和放疗在内的保守手术。在中位随访期49.2个月期间，有12例患者出现乳腺复发（4.8%）。4例患者的复发发生在与原发灶相同的象限，而另外8例患者的复发累及不同象限。60岁以下女性的复发率为5%，老年患者为4.7%，p = 0.73。pT1患者的复发率为4.5%，pT2患者为7.9%（p = 0.37）。pN-和pN+患者之间未观察到显著差异（4.5%对6.25%，p = 0.37）。在我们的系列研究中，所研究的因素均未显著影响乳腺复发率。相对于较低的复发率，患者数量可能过少。然而，在60岁以下患者、pT2或pN+患者，或手术切缘阳性或不明的患者中观察到了不利趋势。
