Japanese Journal of Clinical Oncology 33:61-67 (2003)
© 2003 Foundation for Promotion of Cancer Research
Long-term Results of Breast-conserving Treatment for Early-stage Breast Cancer in Japanese Women from Multicenter Investigation
1 National Shikoku Cancer Center, Matsuyama, 2 Cancer Institute, Tokyo, 3 Osaka Medical Center for Cancer and Cardiovascular Disease, Osaka, 4 Osaka National Hospital, Osaka, 5 Saitama Cancer Center, Ina, Saitama, 6 Mitsui Memorial Hospital, Tokyo, 7 St. Luke’s International Hospital, Tokyo, 8 Gunma University, Maebashi, 9 Aichi Cancer Center Hospital, Nagoya, 10 Keio University, Tokyo, 11 Kure National Hospital, Kure, Hiroshima, 12 National Cancer Center Central Hospital, Tokyo, 13 University of Tokushima, Tokushima, 14 Niigata Cancer Center Hospital, Niigata, 15 Urayasu Hospital of Juntendo University School of Medicine, Urayasu, Chiba, 16 Fukuyama National Hospital, Fukuyama, Hiroshima, 17 Tokyo Women’s Medical University, Tokyo and 18 Sapporo National Hospital, Sapporo, Japan
Background: Although many clinical data regarding breast-conserving treatment have already been reported from European and North American countries, few clinical data with long-term follow-up have been reported from Japan.
Method: We collected information on therapeutic and possible or developed prognostic factors and follow-up data for Japanese women who had received breast-conserving treatment consisting of wide excision of the primary tumor, axillary dissection and radiotherapy for unilateral breast cancer considered suitable for breast-conserving treatment from 18 Japanese major breast cancer treating hospitals; 1561 patients were registered.
Results: The median follow-up period was 77 months. Five-year disease-free and overall survival rates were 89.4 and 95.9%, respectively. The 5-year local recurrence-free rate was 96.3%. The patients with histologically positive margins (P < 0.0001) or estrogen receptor negative tumor (P = 0.0340) or younger than 40 years old (P < 0.0001) developed statistically significantly more local recurrences. Adjuvant endocrine therapy was essential for the estrogen receptor positive patients to have a lower local recurrence rate. Endocrine therapy did not change the local recurrence rate among estrogen receptor negative patients at all. Multivariate analysis showed histological margin status and the combination of estrogen receptor status and endocrine therapy were independent prognostic factors for local recurrence.
Conclusion: The 5-year local recurrence rate of Japanese breast cancer patients who were treated with breast-conserving treatment using radiotherapy was 3.7%. Independent prognostic factors for local recurrence were histological margin status and the combination of estrogen receptor status and adjuvant endocrine therapy.
+ For reprints and all correspondence: Shozo Ohsumi, Department of Surgery, National Shikoku Cancer Center, 13 Hori-no-uchi, Matsuyama, Ehime 790-0007, Japan. E-mail: sosumi@shikoku-cc.go.jp
Abbreviations: RCT, prospective randomized controlled trial; BCT, breast-conserving treatment; JBSG, Japanese BCT Study Group; LR, local recurrence; RT, radiotherapy; ET, endocrine therapy; DCIS, ductal carcinoma in situ; ER, estrogen receptor; PgR, progesterone receptor; HR, hazard ratio; CI, confidence interval
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