J Breast Cancer.  2015 Mar;18(1):36-43. 10.4048/jbc.2015.18.1.36.

Operable Breast Cancer of the Inner Hemisphere Is Associated with Poor Survival

• Xue C
• Peng RJ
• Wang SS
• Shi YX
• An X
• Xu F
• Yuan ZY

• KMID: 2286335
• DOI: http://doi.org/10.4048/jbc.2015.18.1.36

Abstract

PURPOSE
This study investigated the clinicopathological features of operable breast cancer lesions located in different hemispheres of the breast and determined related survival outcomes.
METHODS
Data from 5,330 patients with invasive ductal carcinoma were retrospectively analyzed based on tumor location.
RESULTS
The median follow-up time was 68 months (range, 18-176 months). Patients with breast cancer located in the outer hemisphere of the breast had lesions with more advanced nodal stages and more frequently received adjuvant chemotherapy than patients with breast cancer in the inner hemisphere. The 5-year disease-free survival (DFS) rates of patients with tumors located in outer versus inner hemispheres were 81.5% and 77.0%, respectively (p=0.004); the overall survival (OS) rates were 90.7% and 88.8%, respectively (p<0.001). The association between tumor location and the 5-year DFS rate was most apparent in node-positive patients (73.1% vs. 65.8% for outer vs. inner hemisphere lesions, p<0.001) and in patients with primary tumors greater than 2 cm in diameter (78.2% vs. 72.3%, p=0.002). Multivariate analysis showed that tumor location was an independent predictor of DFS (hazard ratio [HR], 1.23; p=0.002) and OS (HR, 1.28; p=0.006). There were no significant differences in 5-year DFS or OS rates between patients with outer versus inner hemisphere tumors when internal mammary node irradiation was performed.
CONCLUSION
This study demonstrated that tumor location was an independent prognostic factor for operable breast cancer. Internal mammary node irradiation is recommended for patients with breast cancer of the inner hemisphere and positive axillary lymph nodes or large primary tumors.

Keyword

Anatomy; Breast neoplasms; Radiotherapy; Recurrence; Survival

MeSH Terms

Breast
Breast Neoplasms*
Carcinoma, Ductal
Chemotherapy, Adjuvant
Disease-Free Survival
Follow-Up Studies
Humans
Lymph Nodes
Multivariate Analysis
Radiotherapy
Recurrence
Retrospective Studies

Figure

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  Figure 1 Five-year disease-free survival (DFS) and overall survival (OS) rates by location of breast cancer in different hemispheres (n=5,330). (A) The 5-year DFS. (B) The 5-year OS.

• 

  Figure 2 Five-year disease-free survival (DFS) and overall survival (OS) rates for patients who were lymph node positive (n=2,653) or had tumors larger than 2 cm in diameter (n=3,687) by location of breast cancer in different hemispheres. (A) The 5-year DFS for patients who were lymph node positive. (B) The 5-year OS for patients who were lymph node positive. (C) The 5-year DFS for patients who had tumors larger than 2 cm in diameter. (D) The 5-year OS for patients who had tumors larger than 2 cm in diameter.

• 

  Figure 3 Five-year disease-free survival (DFS) and overall survival (OS) rates for patients who received additional internal mammary nodes radiotherapy (IMNRT) or not (in those with regional radiotherapy, n=1,201). (A) The 5-year DFS. (B) The 5-year OS.

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