The role of prognostic factors on breast cancer recurrence in patients at radiation oncology ward in Imam Hossain hospital

Survival of patients with breast cancer is affected by factors such as involved lymph nodes, tumor size, hormone receptors and kind of treatment, so recognizing and investigation of each one especially in patients in Iran is so important.

In this study, we had 88 patients with breast cancer, T1, T2, T3, N0, N1, who had taken adjuvant therapies such as radiotherapy, chemotherapy, Tamoxifen, ovarian ablation, combination of 2 or more therapies or even one kind treatment after surgery. Then patients were followed up for 2-3 years and were investigated for prognostic recurrence factors. The results were analysed by X2 test and Fisher test.

Free Disease Survival (FDS) and total survival were 77.3% and 87.5% respectively and 23% of patients had recurrence (20 patients).12.5% (11patients) passed away. The most common site of metastases was bone. Patients with involved lymph nodes had 32% higher recurrence than the patients without involved lymph node. Patients with T2 tumor, had 17% higher recurrence than patients with T1 tumors. But patients at T3 stage had 9% lower recurrence in comparison with T2 stage and according to equal prognostic factors, they had 21% lower recurrence. Menopausal status did not any influence on tumor recurrence. Patients with positive estrogen receptor had lower recurrence (10% versus 25%).In few patients with ovarian ablation, there was no recurrence (P<0.001). Patients, who had taken breast conservative surgery, did not have any recurrence. Chemotherapy including 4 courses Adriamycine and then 4 courses CMF versus 6 courses CMF in patients with involved lymph nodes more than 3, and in T2 or T3 there was 13% lower recurrence rate in first group. Finally, patients with positive lymph node who had radiation therapy with other treatments, there was only 10% recurrence and we had 90% locally control.

If treatment is accomplished at primary stages with no lymph node involvement, there will be higher survival in breast cancer.