Survival analysis according to period and analysis of the factors influencing changes in survival in patients with recurrent breast cancer: a large-scale, single-center study
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We performed this study to analyze changing survival patterns regarding recurrent breast cancer in Korea during the last 16 years (1993–2008). We also sought to determine factors possibly influencing outcomes and changes over time in the duration of survival after recurrence.
We retrospectively analyzed 9671 patients with breast cancer treated between January 1993 and December 2008, comparing the periods 1993–2002 and 2003–2008.We retrospectively reviewed the collected database including the age at diagnosis, clinical manifestations, pathology report, surgical methods, types of adjuvant treatment modalities, type of recurrence, and follow-up period.
There were 1944 cases (20.1%) of recurrence. Median age at the first recurrence was 49.5 years (range 21.8–92.9). Median follow-up was 28.8 months (range 0–228.0) from the time of relapse. Median survival time was 35.0 months. Survival after recurrence (SAR) significantly improved in 2003–2008 compared to that in 1993–2002. Median survival time increased from 27.6 months in the period I to 42.3 months in period II (p = 0.001). Independent prognostic factors after the first recurrence by multivariate analysis were age at diagnosis, tumor size, nodal status, tumor grade, subtype, anti-hormonal therapy, time at diagnosis, and disease-free interval.
Outcomes of breast cancer have been improving recently, and survival time after the first recurrence of breast cancer has steadily increased in recent decades. We confirmed that advances in treatments have contributed to this improvement in survival after the first recurrence.
KeywordsBreast cancer Survival Prognostic factor Recurrence
This study was supported by a grant (2012-510, 2013-510) from Asan Institute for Life Sciences, Asan Medical Center, Seoul, Korea. The authors thank all clinical surgeons for collecting data. SB Lee and SH Ahn substantially contributed to the conception and design of the study, and to the analysis and interpretation of the data; SB Lee drafted the paper, and all authors revised the paper for intellectual content and approved the final version of the paper.
Compliance with ethical standards
Conflict of interest
The authors do not have any conflicts of interests to disclose.
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