Can a subgroup of node-negative breast carcinoma patients with T1-2 tumor who may benefit from postmastectomy radiotherapy be identified?

Purpose: To determine a subgroup of T1-2N0 breast carcinoma patients at high risk for local recurrence. Methods and Materials: In this retrospective study, univariate and multivariate prognostic factor analyses for local recurrence and distant recurrence were carried out in 502 patients. Results: During the median observation time of 77 months (range, 24-191 months), 14 patients (2.8%) had local recurrence and 55 (11.0%) had distant recurrence. Tumor size (continuous, p = 0.03; hazard ratio [HR] 1.2; 95 % confidence interval [CI], 1.1-1.7), grade (p = 0.01; HR, 2.4; 95% CI, 1.2-5.0), lymphatic vascular invasion (LVI) (p = 0.01; HR, 10.0; 95% CL 2.4-17.3), estrogen receptor status (p = 0.01; HR, 6.3; 95% CI, 2.0-23.0) and cErbB2 status (p = 0.01; HR, 10.0; 95% CI 1.8-87.5) were strongly associated with distant recurrence. Tumor size <=:52 cm vs. >2 cm; p = 0.05; HR, 5.4; 95% CI, 1.2-28.0) and LVI (p = 0.004; HR, 9.0; 95% CI, 2.0-41.0) in patients aged <= 40 years, and tumor size (<= 3 cm vs. > 3 cm; p = 0.05; HR 8.6; 95 % C1 1.3-75.0), LVI (p = 0.007; HR, 18.0; 95 % CI, 2.1-153.0), and grade (p = 0.05; HR, 7.0; 95 % CL 1.2- 63.0) in patients aged > 40 years were the most important predictive factors for local recurrence. Conclusions: Among breast carcinoma patients, young patients with tumor size >2 cm and LVI and older patients with tumor size >3 cm, LVI, and high-grade tumor had a high risk of local recurrence. ((C) 2007 Elsevier Inc.