Patterns of the Recurrence of Breast Cancer in Korean Female Patients

Kim, Hark Kyun; Heo, Dae Seog; Bang, Yung Jue; Kim, Noe Kyeong

Abstract

PURPOSE: The major aim of this study is to evaluate the pattems of recurrence of breast cancer and to determine risk factom influencing the pattem.
MATERIALS AND METHODS
Medical records of 322 female patients who underwent mastectomy from 1989 till 1992 were reviewed. Recurrence pattem and the length of survival after the first relapse of each relapsed patient were identified. Factors influencing the pattem of recurrence and the length of survival after relapse were analyzed using Cox proportional hazards model.
RESULTS
Locoregional relapse was identified in the first failure sites of sixteen patients (5-year relapse rate, 5.7%). Risk of locoregional relapse was associated with the number of positive axillary lymph nodes [adjusted Relative Risk (aRR), 31.28 (95% Confidence Interval (CI), 6.81-143.77)]. The 5-year estimates of the first relapse at bone, lung, pleura, liver, and brain were 15.4%, 6.9%, 1.9%, 3.1%, and 0.8%, respectively. The multivariate analysis indicated that distant metastasis was associated with the number of positive axillary lymph nodes [aRR, 3.14 (95% CI, 1.56-6.32)] and with the age of 35 years and younger [aRR, 1.95 (95% CI, 1.01-3.75)]. The statistical association of negative estrogen receptor (ER) with distant relapse was borderline [aRR, 1.89 (95% CI, 0.99-3.61)]. Factors independently affecting the survival of relapsed patients were the pattem of metastasis and the disease-free interval.
CONCLUSION
Bone metastasis was the most frequent pattem of first relapse in Korean breast cancer patients. The number of positive axillary lymph nodes, younger age, and negative ER were independent risk factors for distant relapse in Korean female breast cancer patients.