FACTORS ASSOCIATED WITH LOCAL BREAST-CANCER RECURRENCE AFTER LUMPECTOMY ALONE

Background: The purpose was to determine the rate of local breast rela pse in patients with breast cancer uniformly treated with partial mast ectomy but without postoperative radiotherapy and without systemic adj uvant therapy. We also systematically examined the factors associated with local recurrence to determine whether a low-risk subgroup existed . Methods: A retrospective review of a prospectively followed (median, 8 years) cohort of 293 patients was performed. The end-point was ipsi lateral local breast cancer recurrence. The patient's age, tumor size, nodal status, estrogen and progesterone receptor status, histology, a nd tumor and nuclear grade were studied, as were the presence and amou nt of carcinoma in situ and the presence of tumor emboli using univari ate Kaplan-Meier and Cox step-wise multivariate analyses. Results: The overall local relapse rate was 26% (77 recurrences). Univariate facto rs significantly associated with decreased local relapse included olde r age, negative nodes, small tumor size, positive estrogen receptor st atus, and absence of tumor emboli. Significant multivariate variables were age, nodal status, estrogen receptor status, absence of comedo ca rcinoma in situ, and tumor emboli. A low-risk subgroup of 66 patients was defined with a 6% 10-year local recurrence rate. Conclusion: Impor tant patient and tumor variables associated with local breast cancer r elapse after breast-conserving surgery can define a low-risk subgroup.