EARLY BREAST-CANCER - EVALUATION OF THE PROGNOSTIC ROLE OF THE SITE OF THE PRIMARY TUMOR

Purpose: The prognostic role of the site of the primary breast cancer has not been clarified. This study aimed to gather more information ab out this issue from a large series of patients with long-term follow-u p data. Patients and Methods: Data from 2,396 patients treated for ear ly breast cancer with a conservative approach were reviewed (1973 to 1 989). In 1,619 patients, the tumor had a lateral site, while in 777 ca ses, it was situated in the internal/central quadrants. The characteri stics of the two groups were well balanced, apart from axillary nodal metastases, which were more frequent for lateral tumors (38.1% v 26.3% ). Results: Analysis of distant metastases indicated that the regressi on coefficient associated with tumor site was significant and the haza rds ratio estimate was 1.291, which indicates the risk of distant meta stases was increased by approximately 30% for internal/central tumors. The analysis of overall survival yielded a significant coefficient an d a hazards ratio of 1.192, which indicates an approximately 20% incre ase of mortality for internal/central tumors. Conclusion: Early breast cancers situated in central/internal quadrants have a worse prognosis compared with those in lateral quadrants, in terms of distant metasta ses and survival. Irradiation of the internal mammary chain for intern al/medial rumors could be suggested, but, to date, the therapeutic str ategy is still controversial. (C) 1998 by American Society of Clinical Oncology.