Indicators of loco-regional recurrence in breast cancer

Aim: The aim of the investigation was to contribute to the identification o f patients who have increased or decreased risk of loco-regional recurrence . Methods: Six hundred and twenty-nine consecutive patients with primary brea st cancer diagnosed between 1988 and 1990 were studied. Two-thirds of the p atients underwent mastectomy. Radiotherapy was administered if patients wer e node positive or breast conserved. The Nottingham histological grading pr otocol was used and presence of lymphovascular invasion was assessed. Inves tigated parameters were: age, size, grade, steroid receptor content, surgic al radicality, vascular invasion and nodal status. Statistically significan t risk factors for loco-regional recurrence using univariate or Cox proport ional hazard analysis were grade and lymphovascular invasion. Results: Women with grade 1-2, node-negative tumours without vascular invas ion had a very low loco-regional recurrence rate-3.1%. Seventeen percent of patients with grade 3 tumours and vessel invasion had loco-regional recurr ence. Conclusions: Our findings, and those of others, indicate that the use of ad juvant radiotherapy should be influenced to a greater extent by grade and l ymphovascular invasion. (C) 2000 Harcourt Publishers Ltd.