Clinical and Pathologic Risk Factors of Tumor Recurrence in Patients With Node-Negative Early Breast Cancer After Mastectomy

Background and ObjectivesPatients with node-negative breast cancer (NNBC) usually have a good prognosis, but tumor recurrence still compromises survival. In this study, we sought to identify clinical and pathologic factors that predict recurrence. MethodsA total of 716 patients who were proved with pT1-2N0M0 breast cancer between 2005 and 2009 were enrolled in this study. ResultsForty-seven of the 716 patients developed tumor recurrence during the 47.0 months of median follow-up. The significant risk factors of recurrence were lymphovascular invasion (LVI) (hazard ratio [HR]=4.60, 95% CI. 2.32-9.10) and Nottingham grade 3 (HR=4.99, 95% CI. 1.06-23.48); adjuvant radiotherapy (HR=0.35, 95% CI. 0.14-0.92) prevented tumor recurrence. Furthermore, we investigate the therapeutic impact of adjuvant chemotherapy and radiotherapy on patients with LVI and Nottingham grade 3. The adverse effect of LVI and grade 3 can be abrogated by adjuvant radiotherapy in recurrence-free survival (RFS) (LVI((+))radiotherapy((+)), no recurrence; grade 3((+))radiotherapy((+)), HR=0.82, 95% CI. 0.18-3.70). However, adjuvant chemotherapy did not. ConclusionsLVI and Nottingham grade 3 were the independent risk factors predicting tumor recurrence for patients with NNBC. Adjuvant radiotherapy might be considered in NNBC patients with these unfavorable factors to improve the RFS. J. Surg. Oncol. 2013; 108:352-357. (c) 2013 Wiley Periodicals, Inc.