Abstract
Background: Locally advanced (stage III) breast cancer has high local recurrence and distant metastasis rates and its prognosis is poor. Multimodal local treatment consisting of surgery/radiotherapy after chemotherapy is generally recommended. However, there are few reports on the treatment and prognosis of locally advanced breast cancer. In this study, we examined the treatment and prognosis of locally advanced breast cancer at our institution.
Patients and methods: We retrospectively examined the clinicopathological factors and prognosis of 76 patients with locally advanced breast cancer treated at our hospital from January 2007 to September 2020.
Results: The median patient age was 62.5 years (range, 31–101). Fifteen women were premenopausal and 61 were postmenopausal. The median tumor diameter was 5.3 cm (range, 1.5–11.0). Fifty-five cases were hormone receptor-positive, 21 were hormone receptor-negative, 11 were HER2-positive, and 64 were HER2-negative. Mastectomy was performed in 62 cases, partial resection in 14, sentinel lymph node biopsy in 15, and axillary dissection in 60. Thirty-one patients received postoperative radiotherapy. Chemotherapy was administered preoperatively in 47 cases and postoperatively in 34, and 48 received postoperative endocrine therapy. The chemotherapy consisted of anthracycline alone in 7 cases, a taxane alone in 4 cases, and a combination of anthracycline and a taxane in 44 cases. The median observation period was 43 months (range, 1–175), during which there were 25 recurrences and 18 deaths. Median recurrence-free survival was 38 months; the 5-year recurrence-free survival rate was 65.6% and the 5-year overall survival rate was 77.9%. Patients with recurrence were significantly more likely to be premenopausal and to have 4 or more lymph node metastases than those who remained recurrence-free. Multivariate analysis identified the number of lymph node metastases as a significant factor affecting recurrence-free survival.
Conclusion: Premenopausal status and presence of 4 or more lymph node metastases were prognostic factors affecting recurrence-free survival. Multimodal treatment should be particularly aggressive in patients with 4 or more lymph node metastases.
Keywords
Locally advanced breast cancer, Multimodality therapy