Patterns of relapse and survival in operable breast carcinoma with positive and negative axillary nodes
Valagussa, P.; Bonadonna, G.; Veronesi, U.
Tumori 64(3): 241-258
1978
ISSN/ISBN: 0300-8916 PMID: 675854 Document Number: 130668
The medical records of 716 patients with infiltrating mammary carcinoma treated during a 4 yr period (Jan. 1964-Jan. 1968) were reviewed. Patients were randomized between conventional radical or extended radical mastectomy. No postoperative radiotherapy or other specific treatments were given without documented evidence of recurrence. The intent of this retrospective analysis was to identify the high-risk groups that could be candidates for systemic adjuvant treatment. The most reliable prognostic discriminant was the histological status of axillary lymph nodes. The 10 yr relapse rate for patients with negative axillary nodes (N-) was 27.9% compared to 75.5% for patients with positive axillary nodes (N+). The corresponding 10 yr survival rates were 81.9 and 39.6%, respectively. The number of involved nodes was also of particular prognostic importance (relapse rates at 10 yr: 1-3 nodes, 66.5%; more than 3 nodes, 83.6%; survival rates: 53.7 and 25.6%, respectively). Other clinical variables (location of primary tumor and menopausal status) failed to significantly affect the results of mastectomy, except for the extent of primary tumor in N+ patients. In this subgroup, relapse and survival rates were directly proportional to tumor size. In both groups, the highest incidence of recurrence was detected in distant organs and tissues, and it progressively increased with time. In contrast, 77.3% of all local-regional recurrences were documented during the first 3 yr from radical surgery.