%0 Journal Article
%T Differential Prognostic Indicators for Locoregional Recurrence, Distant Recurrence, and Death of Breast Cancer
%A Rungnapa Chairat
%A Adisorn Puttisri
%A Asani Pamarapa
%A Jirause Moollaor
%A Chamaiporn Tawichasri
%A Jayanton Patumanond
%J ISRN Oncology
%D 2013
%R 10.1155/2013/946945
%X Objective. To explore prognostic characteristics for locoregional recurrence, distant recurrence, and mortality in patients with breast cancer. Methods. A 5-year retrospective review of patients was conducted in two university affiliated hospitals in the north of Thailand. Prognostic characteristics and clinical outcomes were retrieved from medical registry. Death was verified by the civil database from the Ministry of Interior, direct telephone contact, or by prepaid postcard. Data were analyzed by stratified Cox¡¯s regression proposed by Lunn & McNeil, in which multiple-typed outcomes were analyzed in a single multivariable model. Results. The assembled cohort comprised 829 patients. Under the multivariable analysis, 7 prognostic characteristics were significant prognostic indicators. Positive axillary lymph nodes >3 and presence of lymphovascular invasion (LVI) increased locoregional recurrence, while disease stage 3, positive axillary lymph nodes >3, and radiotherapy increase distant recurrence. Hormonal therapy reduced the distant recurrence. Pathological tumor size >2£¿cm, disease stage 3, positive axillary lymph nodes >3, and presence of LVI increased, while hormonal therapy and chemotherapy reduced death. Conclusions. Clinical characteristic reflecting tumor invasions increased locoregional recurrence, distant recurrence, or death, while hormonal therapy and chemotherapy reduced such risks. The effect of radiation remained inconclusive but may increase the risk of distant recurrence. 1. Introduction Breast cancer is a common medical problem and one of the leading causes of death among malignant conditions in women worldwide [1]. The incidence of breast cancer varied geographically. In Thailand it is the leading cancer among females with continuously increasing trend. The incidence increased from 37.9 in 2007 to 53.8 per 100000 population in 2011. The mortality also rose from 6.8 to 8.4 per 100000 population in the corresponding years [2]. Despite medical progresses in diagnosis and treatments in the past 10 years, recurrence after complete treatment was still common, both locoregional (27%) and distant (11%) [3, 4]. Survival and mortality of breast cancer varied from study to study [3, 5], and the most common cause of death was distant metastasis [5]. One of the most challenging tasks in managing breast cancer cases was disease prognostication of patients who were likely to have recurrence as prompt detection of recurrence may save the patients¡¯ life or increase the survival time [6]. This should be done by risk evaluation of recurrence based on
%U http://www.hindawi.com/journals/isrn.oncology/2013/946945/