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Long-term outcomes and predictors of recurrence in node-negative early stage breast cancer patients

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Abstract

Background

We evaluated the outcomes, and risk factors for recurrence in patients with early stage node-negative breast cancer in this study.

Method

Retrospective data analysis was done on patient treatment records from 1988 to 2018. The patient’s demographic, clinical, pathological, and therapeutic characteristics were noted. To evaluate survival analysis and predictors of recurrence, we employed Kaplan–Meier analysis with the log-rank test.

Results

A total of 357 patients in all were enrolled in the research. At the time of diagnosis, the median age was 50 (with a range of 18–81). A total of 85.5% of patients had undergone a lumpectomy, while 14.5% had a mastectomy. 78.7% of patients had sentinel lymph node biopsy, and 21.3% had axillary lymph node dissection. In addition, the patients received adjuvant radiotherapy (88.7%), adjuvant endocrine therapy (82.1%), and adjuvant chemotherapy (48.5%). Recurrence of the tumor occurred in 31 (8.7%) patients (local recurrence 45.2% and metastatic disease 54.8%). Ten- and twenty-year recurrence-free survival rates were 92% and 77%. 19 (5.3%) patients had also developed contralateral breast cancer. Ten-year survival rates were 91.6%, and 20-year survival rates were 76.6%, respectively. Aged over 65 years (p = 0.004), necrosis (p = 0.002), mitosis (p = 0.003), and nuclear pleomorphism (p = 0.049) were found as statistically significant factors for recurrence in univariate analysis. In the ROC analysis, the largest size of the tumor (over 1.45 cm, p = 0.07) remained outside the statistical significance limit in terms of recurrence.

Conclusions

Thirty-year outcomes in individuals with early stage, node-negative breast cancer were shown in this study. We found that the recurrence ratios between 10 and 20 years were more frequent than the first 10 years during the follow-up. Despite the small number of patients who experienced a recurrence, we demonstrated that, in univariate analysis, being older than 65 and having some pathological characteristics (nuclear pleomorphism, mitosis, and necrosis) were statistically significant factors for disease recurrence.

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Data availability statement

This published paper contains all of the data produced or analyzed during this investigation. Further enquiries can be directed to the corresponding author.

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Funding

Neither financial nor of other nature.

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Authors and Affiliations

  1. Department of Medical Oncology, Istanbul University Institute of Oncology, Medical Oncology, Çapa, Fatih, 34093, Istanbul, Turkey

    Izzet Dogan, Esra Aydin, Nijat Khanmammadov, Nail Paksoy, Ferhat Ferhatoğlu, Naziye Ak, Pinar Saip & Adnan Aydiner

  2. Department of Surgery, Istanbul University, Faculty of Medicine, Istanbul, Turkey

    Selman Emiroglu, Mustafa Tukenmez, Neslihan Cabioglu, Mahmut Muslumanoğlu, Vahit Ozmen & Abdullah Igci

  3. Istanbul University Institute of Oncology, Radiation Oncology, Istanbul, Turkey

    Kamuran Ibis & Seden Kucucuk

  4. Department of Pathology, Istanbul University, Faculty of Medicine, Istanbul, Turkey

    Semen Onder

Authors
  1. Izzet Dogan
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  2. Esra Aydin
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  3. Nijat Khanmammadov
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  4. Nail Paksoy
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  5. Ferhat Ferhatoğlu
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  6. Naziye Ak
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  13. Mahmut Muslumanoğlu
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  14. Vahit Ozmen
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  15. Pinar Saip
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  16. Abdullah Igci
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  17. Adnan Aydiner
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Contributions

Conception and design: Dr. ID and Professor Dr. AA; Development of methodology, analysis, and interpretation of data: Dr. ID; Data acquisition: All authors; Manuscript writing: All authors; Final approval of manuscript: All authors.

Corresponding author

Correspondence to Izzet Dogan.

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Conflict of interest

The authors declared that there are no potential conflicts of interest.

Ethical approval

The academic board approved this study at the Istanbul University Institute of Oncology (Number: 1723150).

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For this type of research, informed consent is not required.

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Dogan, I., Aydin, E., Khanmammadov, N. et al. Long-term outcomes and predictors of recurrence in node-negative early stage breast cancer patients. J Cancer Res Clin Oncol 149, 14833–14841 (2023). https://doi.org/10.1007/s00432-023-05276-y

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  • DOI: https://doi.org/10.1007/s00432-023-05276-y

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