Prognosis of a series of 763 consecutive node-negative invasive breast cancer patients without adjuvant therapy: Analysis of clinicopathological prognostic factor

Background and Objectives: The objectives of this study were to confirm the favorable outcome of Japanese invasive breast cancer patients without lymp h node metastasis, after treatment with surgery alone, and to evaluate clin icopathological prognostic factors in this population. Methods: The subjects were 763 consecutive node-negative invasive breast ca ncer patients who underwent surgery without adjuvant therapies between 1988 and 1993 at our hospital. Disease-free survival (DFS) and overall survival (OS) rates were analyzed by clinicopathological factors. Results: The median age of the patients at surgery was 52 years and the med ian follow-up period of patients was 74 months. At 5 years, the re spective DFS and OS rates of all patients were 90.8% and 93.9%. Patients with a pat hological tumor size of invasive component of more than 2 cm (319 patients) had a significantly lower DFS than those with tumors measuring 2 cm or les s (361 patients) (P = 0.045). Patients with positive hormone receptor statu s (280 patients) (estrogen and/or progesterone receptor positive) tended to have a better OS than those negative for both hormone receptors (92 patien ts) (P = 0.078). Meanwhile, patients with tumors of histological grade 3 (3 28 patients) had a much poorer prognosis than those with tumors of histolog ical grade 1 or 2 (413 patients) (P = 0.008 for OS and P = 0.042 for DFS). The respective 5-year DFS and OS rates of patients with histological grade 3 tumors larger than 2 cm in pathological tumor size of invasive component (195 patients) were 85.5% and 87.6%, indicating that these node-negative pa tients form a high risk group. Conclusions: Japanese invasive breast cancer patients without lymph node me tastasis tended to show a survival advantage compared with their Caucasian counterparts. Histological grade was the most useful prognostic factor in t his population. J. Surg. Oncol. 1999;71:101-105. (C) 1999 Wiley-Liss, Inc.