OBJECTIVETo study the appropriate surgical treatment for breast ductal carcinoma in situ (DCIS).

METHODSTwenty-six such patients treated between 1992 and 2001 were retrospectively analyzed. Among them, 3 patients were treated by simple mastectomy, 23 patients by mastectomy and axillary lymph node dissection, 8 patients by chemotherapy and one patient by radiotherapy after operation. Median follow-up was 42 m (rang 12 - 112 m).

RESULTSExcept 3 of these 26 patients lost in follow-up and 1 patient died from diabetes mellitus, all the other 22 patients survived over 5 years. All lymph nodes dissected from 23 patients were negative. After surgery, 3 patients developed lymph edema of the arm.

CONCLUSIONDCIS, lacking the potential of metastasis, is not invasive. Conservative breast surgery without lymph node dissection is feasible for most DCIS patients.

Adult ; Aged ; Breast Neoplasms ; mortality ; pathology ; surgery ; Carcinoma in Situ ; mortality ; pathology ; surgery ; Carcinoma, Ductal, Breast ; mortality ; pathology ; surgery ; Female ; Humans ; Lymph Node Excision ; Mastectomy ; Middle Aged ; Retrospective Studies

PURPOSE: The optimum local surgical strategy regarding breast-conserving therapy (BCT) for triple-negative breast cancer (TNBC) is controversial. To investigate whether BCT is appropriate for patients with TNBC, we evaluated the clinical outcomes of BCT in women with TNBC compared to those of women without TNBC, using a large, single-center cohort. MATERIALS AND METHODS: We performed a retrospective analysis of 1533 women (TNBC n=321; non-TNBC n=1212) who underwent BCT for primary breast cancer between 2000 and 2010. Clinicopathological characteristics, locoregional recurrence-free survival (LRFS), and overall survival (OS) were analyzed. RESULTS: Tumors from the TNBC group had a higher T stage (T2 37.4% vs. 21.0%, p<0.001), a lower N stage (N0 86.9% vs. 75.5%, p<0.001), and a higher histologic grade (Grade III 66.8% vs. 15.4%, p<0.001) than the non-TNBC group. There were no differences in 5-year LRFS rates between the TNBC and non-TNBC groups (98.7% vs. 97.8%, p=0.63). The non-TNBC group showed a slightly better 5-year OS than the TNBC group; however, the difference was not significant (96.2% vs. 97.3%, p=0.72). In multivariate analyses, TNBC was not associated with poor clinical outcomes in terms of LRFS and OS [hazard ratio (HR) for LRFS=0.37, 95% confidence interval (CI): 0.10-1.31; HR for OS=1.03, 95% CI: 0.31-3.39]. CONCLUSION: TNBC patients who underwent BCT showed non-inferior locoregional recurrence compared to non-TNBC patients with BCT. Thus, BCT is an acceptable surgical approach in patients with TNBC.
Adult ; Aged ; Breast Neoplasms/mortality/pathology/*surgery ; Disease-Free Survival ; Female ; Humans ; *Mastectomy, Segmental ; Middle Aged ; *Neoplasm Recurrence, Local/mortality/pathology ; Proportional Hazards Models ; Retrospective Studies ; Time Factors ; Treatment Outcome ; Triple Negative Breast Neoplasms/mortality/pathology/*surgery

OBJECTIVETo explore the prognosis of benign, borderline and malignant phyllodes tumors of the breast.

METHODSData from 246 women with phyllodes tumors of the breast treated in the Cancer Hospital, Chinese Academy of Medical Sciences between January 2002 and December 2012, were collected and analyzed retrospectively. The patients were followed-up for a median of 48 months (range 1-138 months). Kaplan-Meier analysis and Cox proportional hazard model were used to analyze the factors affecting the disease-free survival.

RESULTSAmong the 246 patients, 65 were dropped out from the follow-up. 56 patients had local recurrence, 5 patients had distant metastasis, while one case had both local recurrence and distant metastasis. The median disease-free survival time was 39 months. Kaplan-Meier survival analysis revealed that fibroadenoma history and type of primary surgery were associated to the disease-free survival of phyllodes tumors of the breast (P<0.001, P=0.043), while histological type and primary tumor size had no significant relationship with the disease-free survival (P=0.083, P=0.974). The multivariate Cox proportional hazard model showed that type of primary surgery, fibroadenoma history and histological types are all independent factors affecting the disease-free survival (P=0.009, P=0.001 and P<0.001).

CONCLUSIONPhyllodes tumors of the breast have a relatively good prognosis on the whole. Type of primary surgery, fibroadenoma history and histological type are independent factors predicting the disease-free survival of patients with phyllodes tumors of the breast.

Breast Neoplasms ; mortality ; pathology ; surgery ; Disease-Free Survival ; Female ; Fibroadenoma ; mortality ; pathology ; surgery ; Follow-Up Studies ; Humans ; Kaplan-Meier Estimate ; Neoplasm Recurrence, Local ; Phyllodes Tumor ; mortality ; pathology ; Prognosis ; Proportional Hazards Models ; Retrospective Studies ; Time Factors

OBJECTIVETo investigate the value of postmastectomy radiotherapy for early breast cancer.

METHODSFrom 1983 to 1991, 605 patients with T1-2N0-1M0 breast cancer were treated by radical mastectomy in our hospital. 149 patients underwent surgery alone(S group), and the remaining 456 patients received further adjuvant treatment. Of these patients, 135 received postoperative radiotherapy(S + R group), 113 adjuvant chemotherapy or tamoxifen(S + Y group), and 208 adjuvant chemotherapy or tamoxifen plus radiotherapy(S + Y + R group). Here, chemotherapy plus tomoxifen is designated as systematically therapy. The locoregional recurrence (LRR), disease-free survival (DFS), and overall survival (OS) rates were calculated by Kaplan-Meier analysis. The differences in locoregional recurrence and survival between these groups were compared by logrank test.

RESULTSThe 10-year actuarial LRR, OS and DFS rates for all patients were 13.4%, 81.6%, and 67.6%, respectively. The 10-year LRR rate was 10.3% for patients with negative axillary nodes, 9.4% for those with 1-3 positive nodes, and 25.9% for those with four or more positive nodes. The locoregional recurrence was significantly higher in patients with four or more positive nodes as compared to those with negative or 1-3 positive nodes (P < 0.05). For the S and S + R groups, the 10-year actuarial LRR rate was 18.7% in the S group and 7.5% in the S + R group (P = 0.017), the corresponding OS and DFS rates of these two groups were 82.1% and 81.1% (P = 0.618), and 65.2% and 71.6% (P = 0.457), respectively. For the S + Y and S + Y + R groups, the 10-year actuarial LRR rate was 21.1% in the S + Y group and 9.5% in the S + Y + R group (P = 0.001), There, the corresponding OS and DFS rates were 75.5% and 85.0% (P = 0.020), and 59.3% and 70.2% (P = 0.003), respectively. Only for patients with four or more positive nodes who had had systematic therapy, radiotherapy was beneficial; the 10-year actuarial LRR of patients who received systematic therapy only was 40.1% as compared with 15.1% of those who received systematic therapy plus radiotherapy; Their OS rates were 55.4% and 67.1% (P = 0.040) and their DFS rates were 30.5% and 57.3% (P = 0.001).

CONCLUSIONPost-mastectomy radiotherapy is able to significantly decrease the locoregional recurrence and improve the survival of patients with four or more positive axillary nodes. We suggest that postmastectomy radiotherapy be given as routine for these patients.

Adult ; Aged ; Breast Neoplasms ; mortality ; pathology ; radiotherapy ; surgery ; Combined Modality Therapy ; Female ; Humans ; Lymphatic Metastasis ; Middle Aged ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Postoperative Care ; Survival Rate

PURPOSE: To determine the effects of new breast cancer treatments and to provide a baseline for monitoring the development of breast cancer in Korean women, we conducted an analysis at our institution to determine long-term clinicopathological features, survival rates, and prognostic factors. MATERIALA AND METHODS: This study retrospectively analyzed 2,403 patients between Sep 1994 and Dec 2002, who underwent breast cancer surgery at Samsung Medical Center in Korea. Demographic data, pathologic records and surgical records were collected. RESULTS: After a median follow-up duration of 121.9 (range: 2-158.1) months, the 5-year disease free survival (DFS) was 82.8% and the 10-year DFS was 74.7%. The 5-year and 10-year overall survival (OS) rates were 89.4% and 82.9%, respectively. Using multivariate analyses, we determined that the nodal status (p < 0.001), angioinvasion (p < 0.001), positive PR (p < 0.001), and C-erb-B2 (p < 0.001) were independent prognostic factors for OS. The frequency of breast conserving surgery was 33.9% before Dec 1999, and increased up to 44.1% by year Dec 2002. CONCLUSION: Most of the prognostic variables and clinical characteristics of the Korean breast cancer patients were similar to those reported for Western populations. However, the age distribution in Korean patients seemed to be different from that in patients from Western countries.
Adult ; Aged ; Aged, 80 and over ; Breast Neoplasms/mortality/pathology/*surgery ; Female ; Follow-Up Studies ; Humans ; Kaplan-Meiers Estimate ; Korea ; Mastectomy/*methods/statistics & numerical data ; Mastectomy, Segmental/*methods/statistics & numerical data ; Middle Aged ; Multivariate Analysis ; Prognosis ; Proportional Hazards Models ; Retrospective Studies ; Survival Rate