Influence of tumor location on breast cancer prognosis

Our objective was to investigate the influence of primary tumor location on breast cancer prognosis. We used a population-based registry since 1977 that has collected detailed information regarding clinical and histopathological presentation, postoperative therapy and follow-up status on Danish women with breast cancer. Nodal status and relative risk of dying was estimated according to primary tumor localization in the breast. Overall, 35,319 patients with primary breast cancer were included in the study. After adjustment for prognostic factors, the risk of dying increased significantly (up to 21%) with increasing distance of tumor location from the axilla. This trend was seen both among women with and without spread to the axillary lymph nodes. In conclusion, survival is significantly better for women with a tumor in the upper lateral quadrant than tumors located elsewhere in the breast. Our finding of a similar trend according to distance from the axilla among women with positive axillary lymph nodes who all are allocated to systemic therapy suggests that a better lymph node staging procedure alone is unlikely to eliminate these survival differences. Other reasons for the observed differences should be sought to help improve survival for women with breast cancer. (C) 2003 Wiley-Liss, Inc.