PROGNOSTIC FACTORS AFTER CONSERVATIVE SURGERY AND RADIATION-THERAPY FOR EARLY-STAGE BREAST-CANCER

A retrospective review was conducted of all early-stage breast cancer patients treated with breast-conservation surgery plus radiation thera py (BCS/RT) to determine mortality and recurrence rates and to evaluat e prognostic factors for these outcomes. Between 1982 and 1988, 121 pa tients with stages I and II breast cancer were treated with BCS/RT at our institution. Most of the patients (83%) had re-excision of the ini tial biopsy site and at final surgical evaluation, only 4 patients had positive margins (3.2%). Median follow-up was 89.7 months. Cox propor tional hazards regression models were used to select prognostic factor s significant for breast cancer-specific mortality, overall disease re currence, and local recurrence. Breast cancer survival rates were 92% at 5 years and 83% at 10 years. Prognostic factors predicting breast c ancer mortality included positive lymph nodes (relative risk = 3.9; 95 % confidence interval, 1.2,12.2) and a higher grade (relative risk = 1 .9; 95% confidence interval, 1.1,3.3). For disease recurrence, prognos tic factors included positive nodes (relative risk = 2.6; 95% confiden ce interval, 1.2,5.5), and a negative progesterone-receptor status (re lative risk = 0.3; 95% confidence interval, 0.2,0.8). Local recurrence rates were 2.5% at 5 years and 14% at 10 years. No prognostic factors were significant for local recurrence; however, most patients had neg ative margins after surgery.