BREAST-CANCER PATIENTS - LONG-TERM RELAPSES

The authors evaluated 200 cases of long-term relapses in patients subj ected to mastectomy at least 8 years before and not given any hormonal or other therapy that would have significantly affected the course of the disease, A group of 200 mastectomy patients with early relapses ( within 3 years) was used as a control, The following parameters were c ompared: hitstologic type, singularity or multiplicity of the relapses at the time of the diagnosis, the patient's age at the time of the ma stectomy, the presence of metastatic lymphnodes at the axilla, the cli nical course of the disease after the diagnosis of relapse, and the pr esence of estrogen receptors in the primary tumor, There was a signifi cant higher incidence of lobular histologic type in the group of patie nts with long-term relapses (p<0.001), The cases with long-term relaps es showed a relatively lower number of relapses in local-region lymphn odes (p<0.005) a higher number of cases with metastases to the axillar y lymphnodes at the time of mastectomy (p<0.001), a better clinical co urse (survival) after the diagnosis (mean 3 vs 2.6 years), and more ca ses with estrogen receptors (p<0.001) than controls, Premenopausal or postmenopausal status at the time of mastectomy was not significant, A fter a review of the literature, the authors conclude that relapses th at appear after 8 years from the mastectomy occur almost exclusively i n patients with a cancer for which the hormonal factor is very importa nt, They hypothesize that even the 18 cases of the series who were wit hout estrogen receptors in reality had receptors saturated by circulat ing estrogens or receptors for other hormones.