유방암의 재발 및 전이 양상

Abstract

Medical records of 460 patients with breast cancer who underwent surgical therapy between January 1982 and February 1993 at the Department of Surgery, Keimyung University Dongsan Medical Center, and out of these, 87 were found to have loco-regional recurrence or distant metastasis or both and analysis of these 87 patients at their initial diagnosis of recurrence showed the following results. 1) The average age of recurrent patients at the time of their initial diagnosis of breast cancer was 45.8 years. 2) Palpable mass(56.4%) was the most common clinical manifestation of recurrence followed by pain(19.6%). 3) Loco-regional recurrence was found in 51 of 87 patients(57.9%), bone metastasis in 29 patients(32.9%), and visceral metastasis in 18 patients(20.4%). Multiple sites of recurrence were found in 7 patients(9.1%). 4) Thirteen of 119(10.9%) patients had a tumor size of 2 cm or less at the time of surgery, 44 of 247(17.8%) with a tumor between 2 and 5 cm, and 30 of 94(31.9%) with a tumor over 5 cm recurred in this study and the difference was statistically significant (p=0.01). 5) Twenty(11.3%) of 177 patients did not have axillary lymph node metastasis, 11(8.9%) of 123 patients had 1 to 3 nodes involved, and 56(35.0%) of 160 patients had four or more nodes involved recurred, and the difference was highly significant (p< 0.001). 6) Infiltrating ductal carcinomas tended to have more frequent recurrence than other histological subtypes(p<0.05). 7) Thirty two patients recurred within a year after initial treatment, 35 patients, between 1 and 3 years, and 20 patients, more than three years after initial treatment.