유방암 환자에서 유방 보존술 후 재발률 및 예후인자

Abstract

Purpose: With better screening methods and patient awareness in recent years, more early stage breast cancers are being found than in the past. The outcome of breast conservation therapy for patients with early stage breastcarcinoma were retrospectively reviewed, and analyses carried out to obtain the 5 and 10 year disease free survival rates and significant prognostic factors. Methods: One hundred and fifty nine breast cancer patients were treated with breast conserving therapy, consisting of wide excision, axillary dissection and radiotherapy, for early stage breast cancer at the Keimyung University Dongsan Medical Center between 1992 and December 2001. The five and 10 year survival rates were obtained using the Kaplan-Meier method and the prognostic factors were studied with univariate and multivariate analyses using SPSS 11.0. Results: The average age at the time of operation was 44.7 years, and the mean tumor size was 1.84 cm. One hundred and eleven patients (69.8%) had pathologically node negative diseases. During a median follow up of 48.7 months, 16 patients developed local and/or systemic recurrences. The 5 and 10 year disease free survivals were 88.0 and 86.0%, respectively. The univariate analysis of the prognostic factors showed that the age at the time of operation (35 years or younger vs. 36 years or older; P=0.0051) and lymph node status (P=0.0015) were statistically significantly associated with a recurrence. The results of the multivariate analysis revealed that the number of axillary lymph node was the strongest independent predictor for a recurrence. Conclusion: A breast conserving procedure is useful and effective for patients with early stage breast cancer, and the axillary status was the strongest independent predictor for a recurrence.